If a patient exhibits a positive Lhermitte's sign, what might be a potential concern for further evaluation?

• A. Dorsal nerve root injury
• B. Cervical myelopathy
• C. Peripheral neuropathy
• D. Muscle strain

Answer: (B)

When a patient exhibits a positive Lhermitte's sign, it indicates a sensation of electric shock-like pain that travels down the spine and into the limbs when the neck is flexed. This symptom is often associated with conditions affecting the spinal cord, particularly myelopathy. Cervical myelopathy involves compression or inflammation of the spinal cord in the cervical region, which can lead to neurological deficits and various sensory or motor dysfunctions.

In this context, a positive Lhermitte's sign suggests that there may be significant involvement of the cervical spinal cord, warranting further evaluation to identify underlying causes such as a herniated disc, degeneration, or demyelinating conditions like multiple sclerosis. The evaluation may include imaging studies like MRI to visualize the spinal cord's integrity and check for compressive lesions or other abnormalities.

The other options pertain to conditions that typically do not produce a positive Lhermitte's sign. For instance, dorsal nerve root injuries or peripheral neuropathies may present with different symptoms, and a muscle strain usually manifests with localized pain during movement rather than the systemic electric shock sensations characteristic of myelopathy. Therefore, recognizing Lhermitte's sign as a marker for potential cervical myelopathy is crucial for guiding further