Lhermitte’s sign (pronounced Ler-meets) is a sudden, intense feeling like that of an electric shock, triggered in people with multiple sclerosis (and other conditions) when they move or flex their neck in a wrong way. The shock sensation can pass down the neck into the spine, and radiate into the arms and legs and, possibly, the trunk.
It was named after Jean Lhermitte, a French neurologist, who described it in an MS patient in 1924. It is also called Lhermitte’s syndrome or barber’s chair syndrome, because the triggering head movement is similar to that done in a barber’s chair for a haircut.
Causes of Lhermitte’s sign
Lhermitte’s sign is due to the damage MS causes to the nerves, particularly demyelination and hyperexcitability. When the head bends forward toward the chest, an awkward and inappropriate communication takes place between damaged nerves and the brain. The brain can interpret these messages as pain, although no physical cause exists. For this reason, Lhermitte’s sign is classified as a neuropathic pain, or nerve pain.
Pain caused by Lhermitte’s sign only lasts for a brief moment, but can be very intense and startling, appearing without warning.
According to two studies, Lhermitte’s sign occurs in 16 of every 100 people with MS, and the likelihood of experiencing it doesn’t appear to depend on age, sex or disability level.
Treatments for Lhermitte’s sign
Lhermitte’s sign often goes untreated, because it occurs so suddenly and passes quickly. But there are things a person can do to treat or try to prevent an attack.
In addition to certain neck movements, fatigue, stress and heat can trigger Lhermitte’s sign, just as they may trigger other MS symptoms. Relaxation techniques like meditation or massage, and deep breathing or stretching exercises may be useful in pain management.
Wearing a soft neck brace may also help in avoiding neck movements, like flexing, that act as triggers.
Electrical stimulating devices, such as TENS (transcutaneous electrical nerve stimulation), use a mild electric current to ease pain. The electrical impulses help to reduce the pain signals and relax the muscles. They may also stimulate the production of endorphins, the body’s natural painkillers.
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