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August 1993

Anatomic-Radiologic Basis of Lhermitte's Sign in Multiple Sclerosis

Author Affiliations

From the Departments of Neurology (Drs Gutrecht and Salgado) and Diagnostic Radiology (Dr Zamani), Lahey Clinic, Burlington, Mass. Dr Zamani is now with the Department of Radiology, Brigham and Women's Hospital, Boston, Mass, and Dr Salgado is in private practice, Gainesville, Fla.

Arch Neurol. 1993;50(8):849-851. doi:10.1001/archneur.1993.00540080056014

• Objective.  —To test the presumption that Lhermitte's sign in multiple sclerosis is the result of a lesion in the cervical spinal cord.

Design.  —The radiologic files of 887 patients with multiple sclerosis were reviewed. A detailed questionnaire regarding Lhermitte's sign was sent to 75 patients who had undergone magnetic resonance imaging of the brain and cervical spinal cord. Of the 64 patients who responded, 55 patients who had complete magnetic resonance imaging files were studied. The cases of two illustrative patients are presented.

Results.  —A strong association between Lhermitte's sign and abnormalities of the cervical spinal cord seen on magnetic resonance imaging was noted. Most of the abnormalities were in the posterior part of the cervical spinal cord.

Conclusions.  —The findings confirm the presumption that a lesion in the posterior columns of the cervical spinal cord is the cause of Lhermitte's sign in multiple sclerosis.

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