title: Lhermitte's Sign Developing after IMRT for Head and Neck Cancer.
abstract: Background. Lhermitte's sign (LS) is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT) for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.
authors.affiliation: Department of Radiation Medicine, Oregon Health & Science University, Mailcode KPV4, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239-3098, USA.
authors.forename: Dong C
authors.initials: DC
authors.lastname: Lim
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gagnon
authors.forename: Sophia
authors.initials: S
authors.lastname: Meranvil
authors.forename: Darryl
authors.initials: D
authors.lastname: Kaurin
authors.forename: Linda
authors.initials: L
authors.lastname: Lipp
authors.forename: John M
authors.initials: JM
authors.lastname: Holland