A sign that is actually a symptom, and not in Unicode anyway

by Michael S. Kaplan, published on 2008/02/03 10:31 -05:00, original URI: http://blogs.msdn.com/b/michkap/archive/2008/02/03/7414197.aspx


I have Lhermitte's sign.

It is named for the French neurologist Jean Lhermitte, who actually has quire a few different medically interesting doodads bearing his name:

You can look at that Wikipedia article about him if you want to see the descriptions of them.

The weirdest one for me is the first one (aka Barber Chair syndrome), which is described as:

...an electrical sensation that runs down the back and into the limbs, and is produced by bending the neck forward. The sign suggests a lesion of the dorsal columns of the cervical cord or of the caudal medulla.

Although it is called a sign, it really is a symptom (it is based on a patient's description rather than something a doctor could independently note) but the name has been around for a shade under 100 years so it is unlikely to change.

It is one of my first symptoms of multiple sclerosis, and to be honest one that I remember from several years before my initial diagnosis.

And it is still with me even today, though only when I cause it by bending my neck forward. Usually for me it only runs down to my fingertips though during acute exacerbations (both genuine and inspired by subclinical illness) I sometimes feel it down my legs as well. It kind of screws up the whole "making a person's toes tingle" notion for me, as it is kind of like my waking state, and if I kiss a person of typical ideal kissing height for me while standing up then I will feel tingling in my limbs independent of how good or bad the kiss is.

Though I recommend leaning me against something or I will fall since I usually close my eyes when I kiss, which causes another sign I'll talk about another time....

It is particularly bad at the moment, which is why I am writing about it.

 

This post brought to you by(U+0981, aka BENGALI SIGN CANDRABINDU)


# Dana on 3 Feb 2008 11:50 AM:

What exactly is the "typical ideal kissing height for me while standing up"?

# Michael S. Kaplan on 3 Feb 2008 12:47 PM:

Yeesh Dana, that one probably deserves its own blog!

# Kemp on 3 Feb 2008 1:24 PM:

I get that, but it stays confined to my back. My limbs are tingle-free with neck bending. I hope that's normal... :-|

# Kemp on 3 Feb 2008 1:27 PM:

Hmm... except now it's doing the whole shebang apparently. It's like itching or yawning, once it's mentioned it's guaranteed to happen.

# John Cowan on 3 Feb 2008 3:05 PM:

I sympathize.  As a type II diabetic, I have the same paraesthesia in my feet, only all the time.  "Toes tingling" is all too real for me.  It reminds me, 24/7, as nothing else could, what a sneaky insidious disease diabetes is, and what a limited amount even the best sugar control can do to improve either lifespan or survival for a given period.

# Michael S. Kaplan on 3 Feb 2008 9:55 PM:

Hi John,

It's funny, having both symptoms at different times (the constant dysethesias and the ones caused by neck flexion) all I can honestly say is the one that is worst is the one I have at that moment (which is a fancy of way of saying I can't really seem to properly judge which is worse!).

Given how I feel about other Sx, the impact on the long term status of the disease seems significant though is not so much of an issue for MS as it can be for diabetes....

Either way, we do share a symptom. :-)

# John Cowan on 4 Feb 2008 9:53 AM:

Yeah, it's a question which is harder to take, a relapsing-remitting disorder or a one-way cumulative one.  When I've lost a capability like walking barefoot (slippers are good), getting an erection (the prosthetic helps), having working kidneys (not yet!) or going blind (not yet!!), it's gone forever, and I'm always wondering whether any little bad experience I have is going to be just temporary or now permanent.  But I've watched SOs go through the relapsing-remitting cycles of Crohn's disease and major depression (both of 'em now recovered entirely, thank Ghu and modern meds), so I know at close second hand just how frustrating that can be.

# Michael S. Kaplan on 4 Feb 2008 10:07 AM:

Yep, sounds like we may have similar beasts on our backs, John (I'll be getting more into mine as this series continues, from time to time).

# Goldie on 4 Feb 2008 4:06 PM:

So what's the partial relevance of the chandrabindu?

# Michael S. Kaplan on 4 Feb 2008 5:57 PM:

There is none, you have to look at the follow-up blog to see relevance added....

# Angela P. on 4 Aug 2008 11:03 AM:

I am so happy for this page!!!!! You have no Idea!!!!!! I have been searching for a long time to find out why I have been shocking myself, badly, I might add and I did not even have to bend my neck to do this....I would have hundreds of shocks a day and the doctors to not seem to care what is causing it! I have been to many doctors going on 5 years. They do not care I have been in pain for this long either...Nothing really shows up in blood work or any other labs...they only want numbers..... Now I have something! Just wait! I have been loosing my eye sight badly as well. Seeing green shades on white...then everything goes back to normal after a few weeks...by the time I get an appointment! I wish I could cram this down every web site that assicoates this sign only with the bending of the neck!  Thank you Thank you Thank you!

amanda on 6 Oct 2010 2:47 PM:

i have no idea why i get this symptom but it happens every day. MY TESTS ARE NORMAL BUT I HAVE NUMB BODY PARTS AND CONTINUOUS SHOCKING SENSATIONS WHEN BENDING MY NECK. i TRY NOT TO DWELL ON IT BUT I KNOW THE DOCTORS ARE MISSING THE TRUE REASON FOR IT. WHO KNOWS AND IM SICK OF TESTS SO I GUESS I WILL JUST LIVE AND HOPEFULLY IT WILL ALL FLY AWAY


referenced by

2010/10/17 No one knows what it's like to be the sad man, to be the bad man, with blue filtered sight!

2008/02/04 On that contrived notion of ideal kissing height, and a mildly interesting and/or ironic language thought or two, as well

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