Lhermitte's Sign: Symptoms, Causes, Diagnosis, and Treatments

Lhermitte’s sign is an electrical-shock sensation linked to multiple sclerosis (MS). It indicates an overactive nervous system. It may be uncomfortable, but this buzzing feeling isn’t deadly. You can manage your pain by reducing stress, getting regular sleep, and treating the underlying cause. Lhermitte’s sign isn’t usually permanent. It may go away in a few weeks. Consult with your primary care team if you develop this sign.

Lhermitte's sign and MS

Multiple sclerosis, or MS, is a long-term, autoimmune disease. Your immune system keeps you safe from infectious invaders. Autoimmune diseases happen when your immune system mistakes your healthy tissue for foreign organisms.

Your body will attack itself by accident, causing a host of symptoms. One of these symptoms could be a positive Lhermitte’s sign.

What is a positive Lhermitte’s sign?

There is no cure for MS. As your body attacks its nervous system, you may develop a positive Lhermitte’s sign. The pronunciation of Lhermitte’s sign is “lher-mitte”.

When you have a positive Lhermitte sign, your body miscommunicates with your nervous system. Your nervous system carries electrical signals from your brain to the rest of your body. When you stretch your neck and trigger a positive Lhermitte sign, your nervous system overreacts to produce a painful sensation.

Lhermitte’s sign isn't constant. It comes and goes. Over time, it may go away on its own.

What does Lhermitte’s sign feel like?

What is Lhermitte’s sign? Lhermitte’s sign is a brief electrical shock feeling when you bring your chin to your chest. Other neck movements can trigger the pain, too.

This sudden shock travels down your neck, spine, and sometimes into your arms or legs. The pain usually goes away when you bring your head back to a neutral position. This type of pain is called nerve pain.

Lhermitte’s sign causes

Changes to the spinal cord in your neck may be causing your Lhermitte's sign. Your spinal cord is a bundle of nerves that connects your brain to the rest of your body. A mass may be putting pressure on your spinal cord. Or, your spinal cord may be injured.

Sometimes, your myelin sheath is impaired. This protective layer covers your nerves. When it's damaged, your nervous system struggles to send messages throughout your body.

Is Lhermitte's sign always MS? Recent research indicates the prevalence in people with MS ranges from 9 to 41%. If your family members have MS and Lhermitte's sign, you have a higher chance of developing MS.

MS isn't the only condition linked to this type of pain.

Lhermitte’s sign may be caused by:

• Meningitis
• B12 deficiency
• Disc herniation
• Cervical spondylitis
• Arnold-Chiari malformation
• Head injury or neck trauma
• Systemic lupus erythematosus

Consult with your healthcare provider to determine the reason for your Lhermitte’s sign. Your healthcare team may perform testing to uncover the cause.

Triggers

Sometimes, things can trigger your Lhermitte's sign. These can be different from person to person.

Some common triggers include:

• Heat
• Stress
• Yawning
• Exhaustion

You may be able to reduce your pain by controlling your triggers.

How do you treat Lhermitte’s sign?

Treating Lhermitte's sign may be different for each person. Your healthcare team will be able to give you advice on how to reduce any discomfort.

Read on to learn more about some common treatments for Lhermitte's sign.

Treat the Underlying Cause

Lhermitte’s sign isn’t a disease. It’s always a sign of an underlying medical condition. If you can treat the cause, you may be able to eliminate the symptom.

Your doctor may recommend surgery if a mass is pushing on your spinal cord, or if a spinal injury is a culprit. Your doctor may prescribe methylprednisolone to treat your MS. Supplemental B12 can reduce any B12 deficiencies. Your healthcare team establishes a treatment plan based on your specific health needs.

Movement

Your doctor may recommend a soft collar for your neck. This supports the proper alignment of your spine. It will also minimize the movement that may trigger your Lhermitte’s sign.

An occupational therapist may recommend specific neck stretches to promote movement with reduced discomfort. Or, they may be able to suggest deep relaxation techniques to encourage muscle relaxation.

Medication

Your doctor may recommend medication to reduce the pain you experience with Lhermitte’s sign. Pain medication, like Acetaminophen or opioids, doesn't treat this type of pain.

Instead, your doctor may recommend medication that focuses on your nervous system. These medications may reduce the over-excitement in your nervous system that causes Lhermitte’s sign.

Medications used to treat Lhermitte’s sign include:

• Lidocaine
• Gabapentin
• Oxcarbazepine
• Carbamazepine

Your doctor may prescribe these medications if other interventions don't work.

Controlling Your Triggers

If you identify a known pattern that causes your Lhermitte’s sign, you can work to minimize your triggers.

Stress reduction can reduce your pain. You can incorporate guided meditation, mindfulness, or deep breathing into your daily schedule. Take breaks throughout the day to check in with yourself and monitor your stress levels.

If exhaustion is your trigger, you should maintain a regular sleep cycle. Try to wake up and fall asleep at the same time every day. Practicing some forms of yoga can encourage sleep. Mindfulness and meditation can also promote deeper sleep.

Monitor your exposure to heat by wearing weather-appropriate clothes in the summer. Drink at least 9 cups (2.13 l) of water to help prevent overheating. Avoid strenuous, outside activity on hot days.

When should you call your doctor?

This nerve pain is uncomfortable, but not life-threatening. Make an appointment to discuss your Lhermitte's sign with your primary care doctor. Your healthcare team may be able to provide a diagnosis for an underlying condition.

The following is a list of frequently asked questions for people experiencing Lhermitte's sign.

Lhermitte’s sign is not uncommon. Have you felt Lhermitte’s sign before? How did it affect you? Share your experience in the comments section and check out our other articles on Multiple Sclerosis.