Multiple sclerosis (MS) is an autoimmune disorder that affects your central nervous system.
Lhermitte’s sign, also called Lhermitte’s phenomenon or the barber chair phenomenon, is often associated with MS. It’s a sudden, uncomfortable sensation that travels from your neck down to your spine. 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 your nerve fibers, destroying myelin and damaging nerves. Your damaged and 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.
Origins of Lhermitte’s sign
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 her 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.
Lhermitte’s sign is caused by nerves that are no longer coated with myelin. These damaged nerves respond to the movement of your neck, which causes sensations from your neck to your spine.
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 recent study suggested that the following can also cause Lhermitte’s sign:
- transverse myelitis
- Bechet’s disease
- disc herniation or spinal cord compression
- severe vitamin B-12 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.
The main symptom of Lhermitte’s sign is an electric sensation that travels down your neck and back. You may also have this feeling in your arms, legs, fingers, and toes. The shocklike 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
According to the Multiple Sclerosis Foundation, around 38 percent of people with MS will experience Lhermitte’s sign. Some possible treatments that may help minimize Lhermitte’s symptoms include:
- medications, such as steroids and anti-seizure 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 anti-seizure drugs to help manage your pain. These medications 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 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. Also, electromagnetic fields directed at areas outside your skull have proven effective in treating Lhermitte’s sign and other common MS symptoms.
Lifestyle changes that may make your symptoms more manageable include:
- a neck brace that can keep you from bending your neck too much and worsening pain
- improving your posture with the help of a physical therapist to help prevent an episode
- deep breathing and stretching exercises to 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. Get plenty of sleep, stay calm, 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 can help you control the effect nerve pain has on your mental health.
Talk with your doctor before changing your behaviors in order to address Lhermitte’s sign.
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 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.
Are there any ways to prevent the likelihood of Lhermitte’s sign?
Yes, there are ways to lower the likelihood of experiencing 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 doctor may prescribe you certain medications (muscle relaxers or antiepileptics) that will help prevent Lhermitte’s sign 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 KimAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.