Lhermitte's sign

A transient, electric shock-like dysesthesia radiating down the spine and often into the limbs, typically triggered by neck flexion and reflecting irritation or dysfunction of the cervical spinal cord dorsal columns or lower brainstem pathways.

Causes

• Neurological causes

  • Multiple sclerosis

  • Neuromyelitis optica spectrum disorder

  • Other demyelinating diseases affecting the cervical spinal cord

• Degenerative spinal causes

  • Cervical spondylosis

  • Herniated cervical discs

  • Cervical spinal stenosis

  • Degenerative cervical myelopathy

• Inflammatory causes

  • Transverse myelitis

  • Systemic lupus erythematosus (SLE)

  • Behçet's disease

  • Other inflammatory myelopathies

• Nutritional and metabolic causes

  • Vitamin B12 deficiency

  • Copper deficiency causing myelopathy

• Structural causes

  • Cervical spinal cord tumors

  • Neck trauma

  • Spinal cord compression

  • Chiari malformation

• Treatment-related causes

  • Radiation-induced myelopathy

  • Chemotherapy-related spinal cord injury or neurotoxicity

• Other causes

  • Infectious myelitis

  • Vascular spinal cord lesions

  • Postoperative cervical cord injury

  • Idiopathic cervical cord irritation