Lhermitte's Sign (and MS): What It Is and How to Treat It
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Lhermitte's Sign (and MS): What It Is and How to Treat It

What Is MS and Lhermitte’s Sign?

Highlights

  1. Lhermitte’s sign is often associated with MS. It is a sudden sensation that travels from your neck to your spine.
  2. People with spinal cord injuries or inflammation, such as cervical spondylitis or disc impingement, might also feel symptoms of the condition.
  3. Through medication, posture adjustment and monitoring, and relaxation techniques, you may be able to minimize Lhermitte’s symptoms.

Multiple sclerosis (MS) is an autoimmune disorder that affects the central nervous system. Lhermitte’s sign, also called Lhermitte’s phenomenon or the barber chair phenomenon, is often associated with MS. It is a sudden, uncomfortable sensation that travels from your neck down to your spine. Lhermitte’s is often described as feeling like an electrical shock or buzzing sensation.

In a typical nervous system, nerve fibers are covered in a protective coating called myelin. In someone with MS, the immune system attacks the nerve fibers, destroying myelin and damaging nerves. The damaged nerves as well as healthy nerves can’t relay messages and cause a variety of physical symptoms, including nerve pain. Lhermitte’s sign is one of several possible symptoms of MS that causes nerve pain.

Lhermitte’s Sign: Origins

Lhermitte’s sign was first documented in 1924 by French neurologist Jean Lhermitte. Lhermitte consulted on a case of a woman who complained of stomach pain, diarrhea, poor coordination on the left side of her body, and an inability to rapidly flex the right hand. These symptoms are consistent with what is now known as multiple sclerosis. The woman also reported an electric sensation in her neck, back, and toes, which was later named Lhermitte’s syndrome.

Causes of Lhermitte’s Sign

Causes Icon

Lhermitte’s sign is caused by nerves that are no longer coated with myelin. These damaged nerves respond to the movement of the neck, which causes sensations from the neck to the spine.

Lhermitte’s sign is common in MS, but it’s not exclusive to the disease. People with spinal cord injuries or inflammation, such as cervical spondylitis or disc impingement, might also feel symptoms of the condition. Severe vitamin B-12 deficiency can also cause symptoms of Lhermitte’s sign. A recent study suggested that the following can also cause Lhermitte’s sign:

  • transverse myelitis
  • behçet’s disease
  • physical trauma

Bending your head to your chest can trigger a feeling of electrical shock. Twisting your neck in any unusual way as well as being tired or overheated can also produce symptoms. Disc herniation and spinal cord compression can also cause you to feel these shocks. Talk to your doctor if you believe that these conditions may be causing you to feel the distinct pain of Lhermitte’s sign.

Symptoms of Lhermitte’s Sign

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The main symptom of Lhermitte’s sign is an electric sensation that travels down your neck and back and also feels present in the arms, legs, fingers, and toes. The pain is usually strongest when you bend your neck forward. The shock-like feeling is often short and intermittent. However, it can feel quite powerful while it lasts. 

Treating Lhermitte’s Sign

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According to the Multiple Sclerosis Foundation (MSF), around 38 percent of MS patients will experience Lhermitte’s sign. However, through medication, posture adjustment and monitoring, and relaxation techniques, you may be able to minimize Lhermitte’s symptoms. Talk to your doctor about potential treatment options that would be best for you.

Medications

Medications can treat the symptoms of Lhermitte’s sign. Some medications used for treatment are anti-seizure drugs and steroids. Anti-seizure drugs help manage the pain by controlling your body’s electrical impulses. Your doctor might prescribe steroids if Lhermitte’s sign is part of a general MS relapse. You might also take medication to lessen the nerve pain that is commonly associated with MS.

Transcutaneous electrical nerve stimulation (TENS) is also effective for some with Lhermitte’s sign. TENS produces an electrical charge to reduce inflammation and pain for a number of medical conditions. Also, electromagnetic fields (EMFs) directed at areas outside the skull have proven effective in treating Lhermitte’s sign and other common MS symptoms.

Lifestyle

Several lifestyle modifications may make you more comfortable. Because neck movements can make Lhermitte’s worse, a neck brace can keep you from bending your neck too much. A physical therapist might suggest improving your posture to help prevent an episode. You might also benefit from deep breathing and stretching exercises to lessen the pain.

MS symptoms like Lhermitte’s sign, especially in the relapsing-remitting form of the condition, often worsen in times of physical or emotional stress. Get plenty of sleep, stay cool, and monitor your stress levels to control your symptoms.

Meditation that encourages you to focus on your emotions and thoughts can also help you manage your nerve pain. Studies show that mindfulness-based interventions (MBIs) can help you control the effect nerve pain has on your mental health.

Talk to your doctor before changing your behaviors in order to address Lhermitte’s sign.

Outlook

Icon Outlook

Lhermitte’s sign can be jarring, especially if you’re not familiar with the condition. See your doctor right away if you begin to feel the symptoms like electric shocks in your body when you bend or flex your neck muscles.

Lhermitte’s sign is a common symptom of MS. If you’ve been diagnosed with MS, seek regular treatment for this and other symptoms that arise. Lhermitte’s sign can be easily controlled if you’re aware of the movements that trigger it. Gradually changing your behavior to minimize the pain and stress of this condition can greatly improve your quality of life.

You Asked, We Answered

  • Are there any ways to prevent the likelihood of Lhermitte’s sign?
  • Yes, there are ways to lower the likelihood of suffering from Lhermitte’s sign. There are certain neck and back exercises you can do for strengthening. Additionally, some simple breathing exercises are helpful. Ask your doctor or physical therapist about which exercises would be best for you.

    If those are not helpful, your physician may prescribe you certain medications (muscle relaxers or antiepileptics) that will help prevent Lhermitte from occurring. Finally, electrical stimulation devices (TENS) have been found to be effective at preventing the condition. As always, speak with your doctor about the best methods for your specific situation. 

    - Dr. Steve Kim
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