Lhermitte's Sign, sometimes called the Barber Chair phenomenon, is 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 often considered a classic finding in multiple sclerosis, it can be caused by a number of conditions, including Behçet's disease,[1] trauma, radiation myelopathy,[2]vitamin B12 deficiency (subacute combined degeneration), and compression of the spinal cord in the neck from any cause such as cervical spondylosis, disc herniation, tumor, and Arnold-Chiari malformation.
Strictly speaking, the Barber Chair phenomenon is a symptom rather than a sign as it describes a subjective sensation rather than an objective finding. To add more confusion, it is not attributed to its discoverer.[3] It was first described by Marie and Chatelin in 1917.[4] Jean Lhermitte did not publish his first report until 1920.[5] However, in 1924 he did publish the seminal article on the subject which resulted in it becoming well known.[6]
Most modern editors prefer the non-possessive form for medical eponyms: Lhermitte sign.
References
^ Page NG, Spiteri MA. Lhermitte's sign in Behçet's disease. Br Med J (Clin Res Ed) 1982 March 6; 284(6317): 704–705.
^ Jones A. Transient radiation myelopathy (with reference to Lhermitte's sign of electrical paraesthesia). Br J Radiol 1964; 37:727-44.
^ Gutrecht JA. Lhermitte's sign: From observation to eponym. Arch Neurol 1989; 46:557-558.
^ Marie P, Chatelin C. Sur certains symptômes vraisemblablement d'origine radiculaire chez les blessés du crâne. Rev Neural 1917; 31:336.
^ Lhermitte JJ. Les formes douloureuses de la commotion de la moelle épinière. Rev Neurol 1920; 36:257-262.
^ Lhermitte JJ, Bollak NM. Les douleurs à type décharge électrique consécutives à la flexion céphalique dans la sclérose en plaques. Un cas de la sclérose multiple. Revue neurologique 1924; 2:56-57.
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