Abstract
Boyun
fleksiyonu ile ekstremitelere ve gövdeye yayılan elektriklenme hissi Lhermitte
bulgusu olarak tanımlanmaktadır ve spinal kordun servikal bölgede etkilenmiş olabileceğini
düşündürmektedir. Altmış dokuz yaşında erkek hastaya servikal spinal stenoz ve
myelopati nedeniyle yapılan C3-4-5 unilateral hemilaminektomi
bilateral dekompresyon sonrası 12. saatte hastanı kollara ve bacaklara yayılan
elektriklenme hissi tariflemesi üzerine yapılan servikal manyetik rezonans
görüntülemesinde operasyon bölgesinde hematom görülmesi üzerine tekrar
operasyona alındı. Hematom boşaltılmasını takiben bu bulgu kayboldu. Lhermitte
bulgusunun görüldüğü klinik durumlar çok çeşitli olabilmektedir. Servikal
kordun posterior kısımlarındaki demiyelinizasyon sonucu ortaya çıktığı
düşünülür. Sensitif bir bulgu olmamasına rağmen servikal kompresif myelopati
için spesifitesi yüksektir. Operasyon sonrası Lhermitte bulgusunun görülmesi
kord kompresyonuna işaret edebileceğinden dikkatli olunmalı ve ileri tetkikler
düşünülmelidir.
Keywords
References
- 1. Khare S, Seth D. Lhermitte’s Sign: The current status. Ann Indian Acad Neurol. 2015;18(2):154-6.
- 2. Newton HB, Rea GL. Lhermitte's sign as a presenting symptom of primary spinal cord tumor. J Neuro-Oncology. 1996;29(2):183-8.
- 3. Mul VE, de Jong JM, Murrer LH, van den Ende PL, Houben RM, Lacko M et al.. Lhermitte sign and myelopathy after irradiation of the cervical spinal cord in radiotherapy treatment of head and neck cancer. Strahlenther Onkol. 2012;188(1):71-6.
- 4. Kempster PA, Rollinson RD. The Lhermitte phenomenon: Variant forms and their significance. J Clin Neurosci. 2008;15(4):379-81.
- 5. Kanchandani R, Howe JG. Lhermitte's sign in multiple sclerosis: a clinical survey and review of the literature. J Neurol Neurosurg Psychiatry. 1982;45(4):308-12.
- 6. Teive HA, Haratz S, Zavala J, Munhoz RP, Scola RH, Werneck LC. Lhermitte’s sign and vitamin B12 deficiency: Case report. Sao Paulo Med J. 2009;127(3):171-3.
- 7. Sagiuchi T, Tachibana S, Sato K, Shimizu S, Kobayashi I, Oka H et al. Lhermitte sign during yawning associated with congenital partial aplasia of the posterior arch of the atlas. AJNR. 2006;27(2):258-60.
Abstract
Lhermitte’s
sign describes an electric shock-like sensation that radiates down the trunk
and limbs with flexion of the neck. This symptom may show injury of spinal cord
at cervical levels. A 69-years-old male had C3-4-5 cervical spinal
stenosis and myelopathy. The patient described an electric shock-like sensation
which radiated to limbs at postoperative 12th hour after C3-4-5 left
sided unilateral hemilaminectomy and bilateral decompression. There was an
epidural hematoma that compressed spinal cord at the level of hemilaminectomy
in magnetic resonance imaging. We performed an immediate surgery and evacuated
the hematoma. Lhermitte’s sign dissapeared after surgery. Lhermitte’s sign
could be seen in various conditions and the pathophysiology is described as the
demyelination of dorsal column of the spinal cord, at the cervical level. It
has poor sensitivity but good specificity in cervical compressive myelopathy.
Postoperative
new onset Lhermitte’s sign can indicate cord compression. The patient must be
evaluated with further examinations.
Keywords
References
- 1. Khare S, Seth D. Lhermitte’s Sign: The current status. Ann Indian Acad Neurol. 2015;18(2):154-6.
- 2. Newton HB, Rea GL. Lhermitte's sign as a presenting symptom of primary spinal cord tumor. J Neuro-Oncology. 1996;29(2):183-8.
- 3. Mul VE, de Jong JM, Murrer LH, van den Ende PL, Houben RM, Lacko M et al.. Lhermitte sign and myelopathy after irradiation of the cervical spinal cord in radiotherapy treatment of head and neck cancer. Strahlenther Onkol. 2012;188(1):71-6.
- 4. Kempster PA, Rollinson RD. The Lhermitte phenomenon: Variant forms and their significance. J Clin Neurosci. 2008;15(4):379-81.
- 5. Kanchandani R, Howe JG. Lhermitte's sign in multiple sclerosis: a clinical survey and review of the literature. J Neurol Neurosurg Psychiatry. 1982;45(4):308-12.
- 6. Teive HA, Haratz S, Zavala J, Munhoz RP, Scola RH, Werneck LC. Lhermitte’s sign and vitamin B12 deficiency: Case report. Sao Paulo Med J. 2009;127(3):171-3.
- 7. Sagiuchi T, Tachibana S, Sato K, Shimizu S, Kobayashi I, Oka H et al. Lhermitte sign during yawning associated with congenital partial aplasia of the posterior arch of the atlas. AJNR. 2006;27(2):258-60.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | April 30, 2019 |
| Submission Date | October 26, 2018 |
| Published in Issue | Year 2019 Volume: 21 Issue: 1 |
Cite
Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.