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Lhermitte’s sign, also called Lhermitte’s phenomenon or the barber chair phenomenon, is often associated with multiple sclerosis (MS).
It’s a sudden, uncomfortable sensation that travels from your neck down your spine when you flex your neck. Lhermitte’s is often described as an electrical shock or buzzing sensation.
Your nerve fibers are covered in a protective coating called myelin. In MS, your immune system attacks and destroys myelin in your brain and spinal cord, which slows down the signal that travels between nerves.
Your nerves can’t relay messages due to the lack of myelin, which causes a variety of physical symptoms, including pain. Lhermitte’s sign is one of several possible MS symptoms that cause pain.
Origins of Lhermitte’s sign
In 1917, French neurologists Pierre Marie and Charles Chatelin became the first people to describe the symptom.
In 1924, French neurologist Jean Lhermitte published the study that’s credited with making the symptom more widely known. He was also the first person to note that the symptom was connected to MS.
Lhermitte consulted on a case of a woman who complained of:
- stomach pain
- poor coordination on the left side of her body
- an inability to rapidly flex her right hand
These symptoms are consistent with what’s now known as MS. The woman also reported an electric sensation in her neck, back, and toes. This sensation was later named Lhermitte’s syndrome.
Lhermitte’s sign mainly results in an electric or wave sensation that travels down your neck and back. You may also have this feeling in your arms, legs, fingers, and toes. The shock-like feeling is often short and intermittent. However, it can feel quite powerful while it lasts.
The pain is usually the most prominent when you:
- bend your head to your chest
- twist your neck in an unusual way
- are tired or overheated
While bending forward or causing the Lhermitte’s sensation is painful, it isn’t dangerous, and it won’t cause further damage to your spinal cord or make your MS worse.
Lhermitte’s sign is caused by nerves that are no longer coated with adequate myelin. This causes a delay in sending signals across the damaged area when there’s pulling or extending of the spinal cord like when your neck is flexed.
Lhermitte’s sign is common in MS, but it’s not exclusive to the condition. People with spinal cord injuries or inflammation might also feel symptoms. A 2015 study suggested that the following can also cause Lhermitte’s sign:
- transverse myelitis, or inflammation in the spinal cord
- Behcet’s disease, an autoimmune disease that causes damaged blood vessels and mouth sores
- disc herniation or spinal cord compression
- severe vitamin B12 deficiency
- physical trauma
Talk with your doctor if you believe that these conditions may be causing you to feel the distinct pain of Lhermitte’s sign.
Some possible treatments that may help minimize the sensations caused by Lhermitte’s sign include:
- medications, such as steroids and antiseizure medications
- posture adjustment and monitoring
- relaxation techniques
Talk with your doctor about which treatment options are best for you.
Medications and procedures
Your doctor may prescribe antiseizure drugs to help manage your pain. These medications help control your body’s electrical impulses. Your doctor might also recommend steroids if Lhermitte’s sign is part of a general MS relapse.
Medication can also lessen the pain that’s commonly associated with MS.
Another procedure to consider is transcutaneous electrical nerve stimulation (TENS). TENS produces an electrical charge that may help to reduce inflammation and pain.
Electromagnetic fields directed at areas outside your skull may also help in treating Lhermitte’s sign and other common MS symptoms.
More conclusive research on this method and TENS is needed.
Lifestyle changes that may make your symptoms more manageable include:
- wearing a neck brace, which can keep you from bending your neck too much and worsening pain
- working with a physical therapist on improving your posture, which can help prevent an episode
- practicing deep breathing and stretching exercises to help lessen your pain
MS symptoms like Lhermitte’s sign, especially in the relapsing-remitting form of MS, often worsen in times of physical or emotional stress.
Meditation that encourages you to focus on your emotions and thoughts can also help you manage your nerve pain. Research shows that mindfulness-based interventions can help you manage the effect that MS pain has on your mental health.
Before changing your behaviors in order to address Lhermitte’s sign, talk with your doctor.
Studies on prevalence are scarce. However, one 2015 study found that 16 percent of people with MS experienced the symptom.
Lhermitte’s sign can be jarring, especially if you’re not familiar with it. See your doctor right away if you begin to feel sensations 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 managed 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.