Sandyk R, Dann L C
NeuroCommunication Research Laboratories, Danbury, CT 06811, USA.
Int J Neurosci. 1995 Apr;81(3-4):215-24. doi: 10.3109/00207459509004888.
Lhermitte's sign, the occurrence of an electrical sensation passing down the back to the legs on flexion of the neck is a common and characteristic feature of multiple sclerosis (MS) which is related to spinal cord lesions affecting the posterior columns and cervical nerve roots. The Lhermitte's sign, which has been reported to occur at some time in up to 25% of MS patients, is seldom painful but is often a cause of distress to the patient and usually a marker of increased disease activity. Treatment with extracranial picotesla range pulsed electromagnetic fields (EMFs) has been found efficacious in the management of various MS symptoms including pain syndromes. The present communication concerns three MS patients in whom two brief applications of EMFs resulted in resolution of the Lhermitte's sign which emerged during a period of exacerbation of symptoms in one patient and during a prolonged phase of symptom deterioration in the other two patients. As the cause of the Lhermitte's sign is thought to result from the spread of ectopic excitation in demyelinated plaques in the cervical and thoracic regions of the spinal cord, it is hypothesized that the effects of EMFs are related to the reduction of axonal excitability via a mechanism involving changes in ionic membrane permeability. A systemic effect on pain control systems is also postulated to occur secondary to the effects of EMFs on neurotransmitter activity and pineal melatonin functions. This report underscores the efficacy of picotesla EMFs in the management of paroxysmal pain symptoms in MS.
莱尔米特征（Lhermitte's sign），即颈部屈曲时出现一种沿背部向下传至腿部的触电样感觉，是多发性硬化症（MS）常见且具有特征性的表现，它与影响后索和颈神经根的脊髓病变有关。据报道，高达25%的MS患者在病程中的某个时候会出现莱尔米特征，该症状很少引起疼痛，但常使患者感到困扰，且通常是疾病活动增加的标志。已发现用颅外皮特斯拉范围的脉冲电磁场（EMF）治疗对包括疼痛综合征在内的各种MS症状有效。本文报道了3例MS患者，其中2例短暂应用EMF后，1例在症状加重期出现的莱尔米特征以及另外2例在症状长期恶化阶段出现的莱尔米特征均得以缓解。由于莱尔米特征被认为是由脊髓颈段和胸段脱髓鞘斑块中异位兴奋的扩散所致，因此推测EMF的作用与通过涉及离子膜通透性改变的机制降低轴突兴奋性有关。还推测EMF对神经递质活性和松果体褪黑素功能的影响继发于对疼痛控制系统的全身性作用。本报告强调了皮特斯拉EMF在治疗MS发作性疼痛症状方面的有效性。
