Lhermitte's sign is tested by passively flexing the patient's head and one hip while keeping the knee in extension. What does a positive test indicate?

Lhermitte's sign is tested by passively flexing the patient's head and one hip while keeping the knee in extension. What does a positive test indicate?

• A. Spinal fracture
• B. Cervical myelopathy
• C. Herniated disc
• D. Peripheral nerve injury

Answer: (B)

A positive Lhermitte's sign, which presents as a sudden, electric shock-like sensation that travels down the spine and into the extremities when the patient's head is flexed, is indicative of cervical myelopathy. This phenomenon occurs due to irritation or injury to the cervical spinal cord, which can happen in various conditions that affect the spinal cord and its surrounding structures. When the head is flexed, it creates tension on the cervical spinal cord, and in cases of cervical myelopathy, this tension leads to the characteristic symptom of Lhermitte's sign. It is often associated with conditions such as multiple sclerosis, cervical spondylotic myelopathy, or other forms of spinal cord pathology, where the integrity of the spinal cord or surrounding structures is compromised. This sign is not commonly associated with spinal fractures, herniated discs, or peripheral nerve injuries. Instead, these conditions typically involve different presentations and symptoms that do not produce the specific elicitation of sensations associated with cervical myelopathy. Therefore, in the context of identifying the underlying pathology, a positive Lhermitte's sign is particularly significant as a clinical marker for potential issues within the cervical spinal cord.

A positive Lhermitte's sign, which presents as a sudden, electric shock-like sensation that travels down the spine and into the extremities when the patient's head is flexed, is indicative of cervical myelopathy. This phenomenon occurs due to irritation or injury to the cervical spinal cord, which can happen in various conditions that affect the spinal cord and its surrounding structures.

When the head is flexed, it creates tension on the cervical spinal cord, and in cases of cervical myelopathy, this tension leads to the characteristic symptom of Lhermitte's sign. It is often associated with conditions such as multiple sclerosis, cervical spondylotic myelopathy, or other forms of spinal cord pathology, where the integrity of the spinal cord or surrounding structures is compromised.

This sign is not commonly associated with spinal fractures, herniated discs, or peripheral nerve injuries. Instead, these conditions typically involve different presentations and symptoms that do not produce the specific elicitation of sensations associated with cervical myelopathy. Therefore, in the context of identifying the underlying pathology, a positive Lhermitte's sign is particularly significant as a clinical marker for potential issues within the cervical spinal cord.