This information on L'Hermittes Syndrome was found on the Medline site. The references were given to me by one of the radiation therapists on the AOL radiotherapy message board. There are three brief abstracts concerning L'HS. I hope you find it interesting. - BDS
HealthGate Document
Record 1 from database: MEDLINE
Title
Lhermitte's sign: incidence and treatment variables influencing
risk after irradiation of the cervical spinal cord.
Author
Fein DA; Marcus RB Jr; Parsons JT; Mendenhall WM; Million RR
Address
Department of Radiation Oncology, University of Florida, College
of Medicine, Gainesville 32610-0385.
Source
Int J Radiat Oncol Biol Phys, 1993 Dec 1, 27:5, 1029-33
Abstract
PURPOSE: Lhermitte's sign is a relatively infrequent sequela of
irradiation of the cervical spinal cord. In this study, we sought
to determine whether various treatment parameters influenced
the likelihood of developing Lhermitte's sign. METHODS AND
MATERIALS: Between October 1964 and December 1987, 2901
patients with malignancies of the upper respiratory tract were
treated at the University of Florida. The dose of radiation to the
cervical spinal cord was calculated for those patients who had
a minimum 1-year follow-up. A total of 1112 patients who received
a minimum of 3000 cGy to at least 2 cm of cervical spinal cord
were included in this analysis. RESULTS: Forty patients (3.6%)
developed Lhermitte's sign. The mean time to development
of Lhermitte's sign after irradiation was 3 months, and the
mean duration of symptoms was 6 months. No patient with
Lhermitte's sign developed transverse myelitis. Several
variables were examined in a univariate analysis, including
total dose to the cervical spinal cord, length of cervical spinal
cord irradiated, dose per fraction, continuous-course compared
with split-course radiotherapy, and once-daily compared with
twice-daily irradiation. Only two variables proved to be
significant. Six (8%) of 75 patients who received > or = 5000 cGy
to the cervical spinal cord developed Lhermitte's sign compared
with 34 (3.3%) of 1037 patients who received < 5000 cGy (p = .04).
For patients treated with once-daily fractionation, 28 (3.4%) of
821 patients who received < 200 cGy per fraction developed
Lhermitte's sign compared with 6 (10%) of 58 patients who
received > or = 200 cGy (p = .02).
CONCLUSION: An increased risk of developing Lhermitte's
sign was demonstrated for patients who received either
> or = 200 cGy per fraction (one fraction per day) or > or = 5000
cGy total dose to the cervical spinal cord.
Language of Publication
English
Unique Identifier
94086380
MeSH Heading (Major)
Lung Neoplasms|*RT; Radiation Injuries|*EP/ET; Radiotherapy|
*AE/MT; Respiratory Tract Neoplasms|*RT; Spinal Cord|*RE
MeSH Heading
Carcinoma|RT; Follow-Up Studies; Human; Lymphoma|
RT; Radiotherapy Dosage; Retrospective Studies; Risk
Factors; Sarcoma|RT; Time Factors
Publication Type
JOURNAL ARTICLE
ISSN
0360-3016
Country of Publication
UNITED STATES
===========================================================================
Record 2 from database: MEDLINE
Title
Protracted Lhermitte's sign following head and neck irradiation.
Author
Thornton AF; Zimberg SH; Greenberg HS; Sullivan MJ
Address
Department of Radiation Oncology, University of Michigan
Hospital, Ann Arbor.
Source
Arch Otolaryngol Head Neck Surg, 1991 Nov, 117:11, 1300-3
Abstract
Lhermitte's sign is a rare complication of head and neck irradiation
involving the delivery of dose to the cervical spinal cord.
Although uncommon, symptoms of lightning-like electric
sensations spreading into both arms, down the dorsal spine,
and into both legs on neck flexion following head and neck
irradiation, causes great concern in both the patient and the
physician. This spontaneously reversible phenomenon is
important for the otolaryngologist and radiation oncologist
to recognize and discuss. A particularly severe and protracted
case of Lhermitte's sign involving a patient recently completing
a radical course of radiation for nasopharyngeal carcinoma is
described in detail, including a review of the literature surrounding
the cause and management of this condition.
Language of Publication
English
Unique Identifier
92082646
MeSH Heading (Major)
Paresthesia|*ET; Radiotherapy|*AE; Spinal Cord|*RE
MeSH Heading
Carcinoma, Squamous Cell|RT; Case Report; Human; Male;
Middle Age; Movement; Nasopharyngeal Neoplasms|RT; Neck
Publication Type
JOURNAL ARTICLE
ISSN
0886-4470
Country of Publication
UNITED STATES
===========================================================================
Record 3 from database: MEDLINE
Title
Electric shock-like sensations in 42 cancer patients: clinical
characteristics and distinct etiologies.
Author
Lossos A; Siegal T
Address
Department of Neurology, Hadassah Hebrew University
Hospital, Jerusalem, Israel.
Source
J Neurooncol, 1996 Aug, 29:2, 175-81
Abstract
We retrospectively evaluated 42 consecutive cancer patients
manifesting electric shock-like sensations. Fourty three
percent presented with Lhermitte's sign (LS), 24% with the
previously described outstretching ir. abduction maneuver
(OAM) of the arms, and 33% had both phenomena. Twenty nine
patients had underlying polyneuropathy related to cisplatin-based
chemotherapy in 27 and to thiamine deficiency in 2. Thirtreen
patients had myelopathy which was induced by radiotherapy
in 11. Patients with polyneuropathy manifested both LS and
OAM, while patients with myelopathy more often presented
with LS. Neurologic signs suggestive of spinal cord involvement
were present in 3 patients with polyneuropathy and in 7 of 11
irradiated patients. MRI disclosed cervical spinal cord swelling
in 3 patients with LS. Prolonged cervical latencies on SSER were
noted in 5 of 15 patients. All had LS and 3 also had OAM
associated with abnormal latencies in the brachial plexi. We
conclude that LS and OAM are positive sensory manifestations
of increased mechanosensitivity of the damaged central or
peripheral sensory axons in the cervico-brachial area. In cancer
patients, these phenomena largely manifest treatment-induced
myelopathy or polyneuropathy. Auxillary studies help to confirm
diagnosis and to depict the uncommon but treatable causes.
Language of Publication
English
Unique Identifier
97011513