March 13, 1981, Vol 245, No. 10 >

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ARTICLE | March 13, 1981

Lhermitte's Sign in Cobalamin (Vitamin B12) Deficiency

William M. Butler, MD; H. Grant Taylor, MD; Louis F. Diehl, MD

JAMA. 1981;245(10):1059. doi:10.1001/jama.1981.03310350047024.

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ABSTRACT

ABSTRACT | REFERENCES

LHERMITTE'S sign (electric shock-like dysesthesia produced by neck flexion) was first described by Marie and Chatelin in 1917.¹ In 1924, Lhermitte et al described in detail a patient with multiple sclerosis and electric dysesthesias.² Since then, Lhermitte's sign has been described in association with tumors of the cervical cord, arachnoiditis, cervical spondylitis, radiation myelitis, subacute combined degeneration of the cord, and nitrous oxide exposure.^3-5 Recently, we have seen two patients with Lhermitte's sign who were found to have cobalamin (vitamin B₁₂) deficiency.

Report of Cases

Case 1.— A 38-year-old woman complained of fatigue and electric dysesthesia with neck flexion for several months prior to evaluation. Examination revealed a mild decrease in vibration and position sense in the extremities.Initial laboratory data included a hemoglobin level of 9.3 g/dL, a leukocyte count of 2.6×10⁹/L, and a platelet count of 330 ×10⁹/L. The blood

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Butler WM, Taylor H, Diehl LF. Lhermitte's Sign in Cobalamin (Vitamin B12) Deficiency. JAMA. 1981;245(10):1059. doi:10.1001/jama.1981.03310350047024.

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