title: Reassessment of Lhermitte's sign in multiple sclerosis.
abstract: The reliability and diagnostic value of Lhermitte's sign in multiple sclerosis (MS) has not been fully established. The purpose of this study was to determine the clinical, neurophysiological and neuroradiological correlations of Lhermitte's sign in a cohort of MS patients and reassess the relevance of this phenomenon in the clinical history of the disease. A prospective study of 694 patients with MS and 110 age-matched healthy adults was evaluated by a structured questionnaire that included basic demographic data, age of onset, clinical characteristics of the disease, and the inquiry of Lhermitte's sign. Cranial and spinal magnetic resonance imagings (MRI) and median and tibial somatosensory evoked potentials (SSEP) were performed at the same time. One hundred and twelve (16 %) patients were reported to have Lhermitte's sign; 582 (84 %) patients did not experience Lhermitte's sign during their disease duration (P < 0.026). No correlation was found between Lhermitte's sign and age, gender, EDSS, and disease duration; 88 % of patients with Lhermitte's sign had a demyelinating lesion on the cervical MRI. In negative Lhermitte's sign group, 64 % patients had a positive MRI. SSEP conductions were delayed in 92 % of patients with positive Lhermitte's sign and in 70 % of patients with negative Lhermitte's sign. Regarding the data, a significant correlation was found between MRI lesion and Lhermitte's sign (P < 0.001), and between SSEP abnormality and Lhermitte's sign as well (P < 0.001). This study underlines the relevance of this phenomenon with neuroradiological and neurophysiological abnormalities.
authors.affiliation: Department of Neurology, Faculty of Medicine, Atatürk Training and Research Hospital, Katip Celebi University, Izmir, Turkey. ybeckmann@gmail.com.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Beckmann
authors.affiliation: Department of Neurology, Faculty of Medicine, 9 Eylül University, Izmir, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Özakbaş
authors.affiliation: Department of Neurology, Faculty of Medicine, Atatürk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
authors.forename: Nazlı Gamze
authors.initials: NG
authors.lastname: Bülbül
authors.affiliation: Department of Neurology, Faculty of Medicine, 9 Eylül University, Izmir, Turkey.
authors.forename: Görkem
authors.initials: G
authors.lastname: Kösehasanoğulları
authors.affiliation: Department of Neurology, Faculty of Medicine, Atatürk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
authors.forename: Yaprak
authors.initials: Y
authors.lastname: Seçil
authors.affiliation: Department of Neurology, Faculty of Medicine, 9 Eylül University, Izmir, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Bulut
authors.affiliation: Department of Neurology, Faculty of Medicine, Atatürk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
authors.forename: Tülay Kurt
authors.initials: TK
authors.lastname: İncesu
authors.affiliation: Department of Neurology, Faculty of Medicine, Atatürk Training and Research Hospital, Katip Celebi University, Izmir, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Tokuçoğlu
authors.affiliation: Department of Neurology, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Cumhur
authors.initials: C
authors.lastname: Ertekin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology*; D009431:Neural Conduction / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Demyelinating lesion; Lhermitte's sign; Multiple sclerosis