Is L'Hermitte's Sign an Indicator of Cord Compression? - Spinal Cord Disorders Message Board

Suzy-Q · 12-15-2006, 09:24 PM

Hello,
I am quite sure I have developed L'Hermitte's sign in the last 3 months. I've only learned of this 'sign' in the last 2 days. I have emailed my NS about this but I don't see him to talk about it until next Tuesday. It is a bit complicated...
I am recovery from a second attempt to fuse L4-5 due to spondylithesis with severe stenosis. My first surgery was in 3-'05 and the revision surgery was in June of this year. My recovery has been, once again, quite rocky. At 4 months there still was no sign of fusion.
Just before my June surgery, i had an MRI for a suddenly worsening neck problem. Sure enough, I have a herniation at C5-6 and spondylosis in that area as well. I have been in PT for this and I have had 2 epis since Aug that seemed to help quite a bit.
But just after the first epi I suffered from some new and strage problems - sudden onset of severe heart palpitations and vertigo. Part of the vertigo was a very ***arre sensation that accompanies head movement. I couldn't get a handle on it. I wasn't sure if it was painful or just what the heck it was. But it went away in early Nov so I just wished it good riddance. But now it is back again and along with it I am having horrific cramps all over my upper torso. I mean I am having cramps in my ribcage, my biceps, and am armpit to say nothing of the severe cramps (spasms?) I have had across my neck and back. And now when my old funny feeling hits me as I move my head, I find it is like an electrical jolt that goes right down my arms, spinal cord, and into my legs (calves most often but also my feet).
Internet research suggests this is L'Hermitte's Sign and a common problem for people with cervical spondylosis. OK, so I think I know what it is. But I don't know whether it is seen in just nerve root compression cases or only spinal cord compression cases?
I am loathe to face another surgery. I would like to hope that it might not be that serious a symptom. I understand that cord compression is nothing to fool around with. But I think I and everyone I know would just flip at the prospect of another surgery. Cart before the horse, I'm sure. thanks for the comments... Suzy-Q

humantunigfork · 12-18-2006, 09:04 AM

L'hermitte's sign is an indicator of cord compression and perhaps in my case one of the most disturbing symptoms...The shocking sensation that pulsed up and down my spine and through my arms and hands was abated to some extent after my surgery C-5C-6 w/hardware...6-23...I had severe cord compression...However after my surgery I still experienced L'hermitte's sign off and on for about 3 months or so...I rarely feel it today...I have inquired on this board before about this troubling symptom and have garnered little response...My sense is that in my case given the spinal cord injury...the myleopathy incurred creates all sorts of neurological symptoms...and some of these may be resolved with time and some may not...I also know that some of those who suffer from MS...also experience this symptom...As you may know the surgery does nothing but get the disk off of the cord...it does nothing for the cord itself...Until we make some progress with stem cell technology our cords must heal themselves for the most part...good luck...HTF

monarog · 12-26-2006, 03:45 PM

I'm not sure if L'Hermitte's is what I'm feeling though after reading HTF's description I very well may be. The feeling for me is constant, though revs up sometimes even more so...it makes me feel horrible. It feels like every nerve in my arms and legs is vibrating, it's terrible. My reflexes are all very strong and even more so when this buzzing feeling is at its strongest. After a large c6-7 herniation (no surgery) and 4-5 months into it all (mind you this all started 15 months ago), this symptom started along with oh so many other neuro symptoms. I have been dealing with this for way too long with no answers. I am pushing for more help and testing, we'll see. Suzy Q...they say I just have mass effect on the c-7 nerve root; though they do note canal narrowing as well. Anyway....I'm still trying to get figured out...I feel horrible, tons of awful neuro symptoms, neck pain etc...it feels all about my neck which they are not really validating at this point...what do I know, I'm just the patient. Good luck.

monarog · 12-26-2006, 05:11 PM

HTF...Are you out there? Your posting name has so caught my eye as it describes how I feel 24/7 - I can't even associate it as positional, though sometimes it kicks in harder than others. I feel absolutely awful...I describe it as all my nerves are "plugged in" - this is the worst of all the myriad of neuro issues I have going on. I guess I'm looking for advice. I had a c6-7 herniation 15 months ago (no surgery). 4-5 months after that all the horrible neuro stuff, numbness, tingling, twitching, dizziness, periodic balance/gait issues, hyper reflexes - you name it. I ended up in the ER 9 months ago...c6-7 herniation still there, "but improving," no cord compression noted etc. I have been through the mill with this, bloodwork, Brain MRI w/ contrast, spinal tap, EMG/NVC - all results "normal." My neck/arm kill me 24/7 and all the neuro stuff is constant. My question...can the MRI somehow not show what is really going on or what other testing can be done to pursue this more? My last MRI was in the ER 9 months ago...my symptoms are very real and they've not been able to find any other cause/disease at this point. My neck and arm pain worsened then the neuro stuff hit and is unrelenting. Any advice from anyone would be appreciated. I keep posting on this board just to vent. I'm trying to stay positive, but I am struggling doing so. This has been hard on my marriage. It is not uncommon for me to be a pile, crying about how bad I feel and knowing something is "terribly wrong," but with no diagnosis or plan to abate these terrible symptoms. My husband is really supportive, but I know this is really tough on him as well. Thanks for advice and for "listening." Mona

Suzy-Q · 12-26-2006, 07:11 PM

Hi Mona and HTF,
Thanks for the replies. Turns out I don't have L'Hermitte's. I still don't have any definite answers but I have more clues. I had a new Cervical MRI done on 12/19 - it shows the same c5-6 herniation but now there is slight spinal cord compression. Also, I had abnormal finger reflexes that my NS says is unequivical for cord compression.
But I have been having severe nausea and the head sensation is really hard to track down. Thing is I can make myself have the same inner stroblight effect just by moving my eyes - no need to turn my head an inch. So, my NS referred me to a neuro cuz he says all this just doesn't add up. Since I left his office on the 19th I have had the worst nausea. I've been on meclizine just to control the vomitting! It just made toast of all the holidays, too.
But I got lucky and they found me a neuro and I will be seen on this Thursday. Of course, the nausea and head sensation has let up a lot tonight! Isn't it always the way? But I will see the neuro and hopefully learn what might explain all this horrible vertigo-like stuff.
I can tell you nausea and a swimming head are no fun but I can't say I envy you, either! I wish you the best of luck - Suzy-Q