Traynelis V C, Hitchon P W, Yuh W T, Kaufman H H
Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242.
J Spinal Disord. 1990 Dec;3(4):376-9.
Two patients developed Lhermitte's sign after cervical spine fractures. The patients were otherwise without evidence of spinal cord dysfunction. Both patients were studied with magnetic resonance scans of the cervical spine. The magnetic resonance scans were normal. The possible etiology of Lhermitte's sign in these patients is discussed. The differential diagnosis including cervical spondylosis, combined systems degeneration, multiple sclerosis, neoplasm, and radiation myelopathy is reviewed. These patients should be carefully evaluated clinically, and flexion/extension lateral cervical spine films as well as a complete blood count and peripheral smear should be obtained. Magnetic resonance scanning may have an important role in evaluating these patients. Magnetic resonance is exquisitely sensitive in detecting demyelination; therefore, we speculate that subarachnoid scarring may be responsible for this symptom. Gadolinium-enhanced magnetic resonance scanning may confirm the presence of such scarring in the future.
两名患者在颈椎骨折后出现了莱尔米特征。除此之外，这两名患者没有脊髓功能障碍的证据。对这两名患者均进行了颈椎磁共振扫描。磁共振扫描结果正常。本文讨论了这些患者出现莱尔米特征的可能病因。回顾了包括颈椎病、联合系统变性、多发性硬化、肿瘤和放射性脊髓病在内的鉴别诊断。应对这些患者进行仔细的临床评估，并拍摄颈椎屈伸侧位片，同时进行全血细胞计数和外周血涂片检查。磁共振扫描在评估这些患者时可能发挥重要作用。磁共振在检测脱髓鞘方面极为敏感；因此，我们推测蛛网膜下腔瘢痕可能是导致该症状的原因。钆增强磁共振扫描未来可能会证实此类瘢痕的存在。
