Lhermitte's sign

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Lhermitte's phenomenon or the Lhermitte phenomenon (/lɛrˈmt/), sometimes called the barber chair phenomenon, is an electrical sensation that runs down the back and into the limbs. The sensation can feel like it goes up or down the spine. It is generally considered uncomfortable.

In many patients, it is elicited by bending the head forward.[1] It can also be evoked when a practitioner pounds on the posterior cervical spine while the neck is flexed; this is caused by involvement of the posterior columns. It is sometimes called Lhermitte's sign, though this is technically incorrect as a sign is something that can be observed on examination whereas a symptom is the subjective experience. Lhermitte's phenomenon is subjective and therefore a symptom.

Lhermitte's phenomenon is named for French neurologist Jean Lhermitte.

Associated conditions[edit]

The sign suggests a lesion or compression of the upper cervical spinal cord or lower brainstem -- usually dorsal columns of the cervical cord or caudal medulla.




In the dental field, three studies (Layzer 1978, Gutmann 1979, Blanco 1983) have identified Lhermitte's sign among nitrous oxide abusers. This is likely due to Nitrous Oxide depletion of vitamin B12 leading to a very severe, rapid deficiency in the absence of supplementation.





  2. ^ Page, NG; Spiteri, MA (Mar 6, 1982). "Lhermitte's sign in Behçet's disease.". British medical journal (Clinical research ed.). 284 (6317): 704–5. doi:10.1136/bmj.284.6317.704. PMC 1496643free to read. PMID 6802294. 
  3. ^ JONES, A (Oct 1964). "TRANSIENT RADIATION MYELOPATHY (WITH REFERENCE TO LHERMITTE'S SIGN OF ELECTRICAL PARAESTHESIA).". The British journal of radiology. 37: 727–44. PMID 14217730. 
  4. ^ Heinzlef, O; Lotz, JP; Roullet, E (May 1998). "Severe neuropathy after high dose carboplatin in three patients receiving multidrug chemotherapy.". Journal of neurology, neurosurgery, and psychiatry. 64 (5): 667–9. doi:10.1136/jnnp.64.5.667. PMC 2170092free to read. PMID 9598687. 
  6. ^ Chan RC.; Steinbock P. (1984). "Delayed onset of Lhermitte's sign following head and/or neck injuries. Report of four cases.". J Neurolosurg. 60 (3): 609–12. doi:10.3171/jns.1984.60.3.0609. PMID 6699706. 
  10. ^ Lhermitte JJ (1920). "Les formes douloureuses de la commotion de la moelle épinière". Rev Neurol. 36: 257–262. 