Lhermitte’s Sign: An Acute Pain Associated with MS
As I was looking down typing one of my articles recently, I experienced a unique pain in my neck. It was one I haven’t felt before. It was a sharp electrifying pain that started on the left side of my neck, and propelled itself on a downward zig-zagging path through my body. Then it was gone as quickly as it had appeared.
The pain left me afraid to move and wondering, “what the heck was that?”
As I did an internet search of multiple sclerosis neck pain, I came across a symptom called Lhermitte’s sign (Lhermitte’s phenomenon, Lhermitte, or barbershop phenomenon). It was something I had never heard of before.
What I gathered from many different online sources was that Lhermitte’s is an electric shock of pain that can run from your head down your back, through your arms and legs. It happens mostly when you bend your head down and touch your chin to your chest.
Lhermitte’s is thought to be caused by a lesion or scar tissue (from damaged nerve cells) that are located on the upper cervical spinal cord or lower brainstem. The lesion or scar tissue blocks impulse messages from the brain and spinal cord, and the electrifying pain is the result.
Lhermitte’s can be painful but not fatal, and most people recover from the symptom with treatment.
It is commonly one of the first symptoms people complain of when they are first diagnosed with MS. It can also be a symptom of many other conditions. It can be connected to anything from vitamin B-12 deficiency, compression of the spinal cord, transverse myelitis, a herniated disc, trauma, a tumor or occur during or after receiving high-dose chemotherapy, to name a few.
It can also accompany the discontinuation of certain psychotropic meds.
Lhermitte’s is most likely to happen when you are fatigued, stressed or overheated.
Some treatment options that your doctor may recommend are:
- Electrical stimulation, using TENS (transcutaneous nerve stimulation). This can ease pain by sending low-voltage electricity to nerves; some devices work outside the body and others are implanted
- A soft neck brace or collar to limit movement
- Massage/muscle relaxation
- Deep breathing
- Meditation
- Stretching
- A physiotherapist, who can offer ways to improve posture
Some medications are an option as well, such as steroids, muscle relaxers, antidepressants, sodium channel blockers, and anti-seizure drugs.
Lhermitte’s may or may not be what I personally experienced, but it is likely. I will schedule a visit soon with my doctor to make sure.
If you suffer from the symptom of Lhermitte’s sign, please share with us your experience and what has helped you.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today, or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.
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Comments
Vivian M. Callender
Timing of your article could not be any better. Yesterday, while driving, late afternoon so am already exhausted from the day's activities, to take my son to a PT evaluation, felt that horrible electrifying shock. Started at the base of my head and then jumped to left side of my head and continued downward. Feels like a hit of a funny bone and is just as painful. Had to pull over and take a few minutes to recover from the acute, sharp pain. Prior to diagnosis in 2010 at age 52 despite experiencing a lifetime variety of symptoms, used to get the Lhermitte's Sign frequently, especially when driving. Thought it was a pinched nerve. ALL of the symptoms made sense after finally having all the dots connected and a diagnosis of MS. Was pleased to learn was not as I had come to believe, an alien :) Lhermitte's makes sense given the myelin neuron damage and interruption of nerve transmissions and possibly empty or damaged axons at the end of the neuron. Thanks for the confirmation.
Debi Wilson
Hi Vivian!
That was timely and especially scary while driving a car I bet! You're welcome for the article, I'm glad it helped!
Wishing you the best! Debi
Meyers
Just stumbled upon this article as I frequently search for any recent Lhermitte's news on the web!
I have been experiencing Lhermitte's sign for just shy of a year and still have no real answers as to what is happening with me. I have had MRI's of both brain and spine which returned clean. B12 levels are normal and all else checks out (spinal cord, discs etc).
Initially the shocking sensation presented itself in a very aggressive and uncomfortable fashion for about a 3-4 week period. After that 3-4 week episode, things began to taper off and just set into what has become a daily routine.
Every single morning when I rise out of bed Lhermitte's is present and gives me a friendly reminder that it is alive and well. After I get up and moving it is hit or miss if I will experience it as it tends to have a mind of its own and just presents at odd points throughout the day.
One thing noted in the article is that it tends to be present during fatigue, stress and overheating. I will attest to this 100%. I am very active and when I get my heart rate up at the gym or my core temp elevates, the shock immediately returns. I am only 34 and have a hard time admitting to fatigue but I am faced daily with comparing myself to my peers and continually wondering why I feel so drained when I am have made so many life choices to prevent Lhermitte's/ fatigue (diet, exercise, no alcohol, sleep, etc)
Based on this quick synopsis of my current condition, I guess I am just writing to share my experience and spark some conversation about this weird issue. I have been seeing a neurologist and we are about to meet at the one year mark. I am going to request another round of MRI's and possibly see about getting a second opinion. I am a young 34 year old presumably healthy male. I would like to exhaust all avenues in order to address what may possibly be MS and get on the prevention sooner than later.
I am rather perplexed at this stage in the game just kind of hanging in the wind.
I appear to be normal but experience buzzing and shocking sensations when I drop my chin. This has affected the way I conduct my day to day activities. I have adjusted the way I live due to this and wonder if things are destined to get worse or revert back to the way the lhermitte's began so aggresively. ....I am trying to be hopeful but am left with so many questions
I think part of me has written this in hopes to find someone who is, or has been in the same situation. I am having a hard time with all of these changes and challenges without being able to talk to someone who experiences it.
thanks for letting me vent!!
Debi Wilson
Hi Meyer's,
Thanks for sharing your experiences. I know the one time I experienced this electrifying pain it was terrifying! So I can't imagine living with it as you do! I hope the Doctors find the cause of your pain soon! Hopefully, some of our readers will share their stories of having Lhermitte's.
Debi
Meyers
Thanks Debi,
I was hoping for at least 1 response by now! I will keep checking back in hopes of finding someone in a similar situation.
Cheers
Greg
46...been getting it over 15 years....I have Ms and some spinal thing at the same time. Started out front chest zapping through my eyes....turned into back zapping through my eyes. Gone through long periods without it...long periods with it....it varies intensity.....less intense lasts longer. Sometimes renders me useless. Just curl in a ball and wait for it to go away. Now I'm getting medium intensity that goes from back arms and settles in my head. I've got nothing to relieve it. I get them when I'm not active....not at gym, but when I'm done....not during work mainly...just on break and my drive home in morning....screws with my appetite..dont wanna eat or prepare food or do anything whem im getting them.oh sometimes I feel it in my throat too.......I'm quite sick of it....neuros just look at me.....all I'm left with is cursing good
Allison
Meyers, have you had the second set of MRIs yet? Wondering how you are. I have the same -- lhermittes and clear MRIs.
Greg
I've been getting it for about 15-20 years....started out in my chest shooting out my eyes.....soon after to my back shooting out my eyes....now just my back to my head and a little in my arms.......I've got no relief, I just have to endure. It comes and goes in spurts that last a few months and I can go just as long without getting any. Sometimes it makes me just curl in a ball and just wait for them to calm down . I get them when at rest.....not when I'm working but when I'm on break...or mentally not preoccupied. I've got Ms and something with my spine that causes it......nothing I can do to relieve it. Causes me to curse good. It's torture...oh well
Terri
Hi there,
Just wanted to share my experience with Lhermitte's Sign. I was 25 y/o and had given birth to my first son approximately 3 months prior...right about the time all those good pregnancy hormones have tapered off. Being a nurse I was familiar with this symptom and its connection with MS so naturally I freaked and went straight to my dr. Who promptly poo poo'd my fears and sent me on my way. Fast forward approximately 10 yrs and a bout of Vertigo that did not respond to Antivert and was sent for a brain MRI which showed lesions and hence won me the dx of MS (score 1 for nurse, 0 for dr.…?) I told my dr. About my experience with Lhermitte's and he sent me for a f/u C-spine MRI...NO LESIONS. None in my T-spine either. I started on Copaxone and have been very healthy for 17 yrs... recently I have developed pins, needles, and numbness in half of my left hand, the medial aspect of my left arm, into the armpit and halfway across my chest and back. New C-spine MRI and now I have a non-enhancing lesion. It's worth noting that I had a C-spine MRI just under 2 yrs ago, at the same facility and no lesions were noted.
My experience with Lhermitte's was not painful as has been previously described but it sure as heck grabbed my attention every time I tipped my chin to my chest.
I'm trying to be patient and am optimistic that these symptoms will resolve in time but cannot deny that I am frightened that this new lesion, in a new area could me something more sinister.
Phyllis Ann Bright
Periodically I experience sudden neck pain that radiates up into my head. It is extremely painful. I was diagnosed with MS in 2000 and have been relatively symptom-free since but am left with leg weakness and fatigue which is managed pretty effectively with Provigil. When this neck pain happens, I need to lie down and try to relax my mind which in turn seems to release the pain. It almost feels like I have pulled a muscle in my neck at the time.
Laurie Byro
I was diagnosed in 2003, but first system was 1988. No brain lesions worth noting they saw one on my C spine in 2003, but I have been blessed (fired over it, but blessed, like Erin Brochovich I got my OWN case resolved and fought 2 town lawyers and a mayor to get my pension yeah me, with a mere Community College Degre) but this "pain" in my foot thing really blows. I called the doctor, she did an MRI but I have yet to meet with her. THANK YOU for those who say it seems to come and go. I had naught for 1 week and it started about a month ago. The heat and stress here during Covid has been intense. I know I am coming to the party late, but anyone? I am bending like a pregnant woman like sideways, afraid to trigger it. And don't know if I should take an Aleave daily?
Laurie
Roger
I'm one month into my Lhermitte sign. I am also having difficulty walking, as my feet are extremely numb and I also experience less, but noticeable numbness in my legs, up to my crotch. My knees feel "wobbly" and climbing stairs is very difficult.
I had COVID and was hospitalized for 6 days about 60 days prior to the onset of Lhermitte.
I've been to a neurologist and had MRI of brain, certical, thorasic and lumber regions. I also had EMG tests as well as a full blood workup. All tests, came back normal. No tumors, stroke, lesions. B12 and all other blood test normal.
Neurologist said, "Go home and be assured nothing is wrong."
But there is something wrong. My Lhermitte is intense and I was running 2 miles 5 days a week only 6 weeks ago. I couldnt run today, if I had to. My legs don't work.
I really think this may be some sort of COVID long haul deal. But I am also concerned about another DX, such as MS.
For now....I'm just waiting. I'm a 57 year old otherwise very healthy male.