Journal List > Korean J Clin Neurophysiol > v.15(2) > 1084124

Ji, Choi, Seo, Chung, Kim, Kim, and Bae: Recurrent Atopic Myelitis Presenting as an Isolated Lhermitte’s Sign

Abstract

Atopic myelitis (AM) is a relatively mild form of myelitis associated with allergic diathesis, and present with predominant sensory manifestations. Lhermitte’s sign has been considered as a relatively non-specific clinical sign suggesting demyelinating lesion in cervical cord. Here we report a patient with recurrent AM who presented with isolated Lhermitte’s sign, both in first and second attacks. This report suggests that either the diagnosis or recurrence of AM can be frequently underdiagnosed because of its predominant sensory manifestations.

REFERENCES

1.Isobe N., Kanamori Y., Yonekawa T., Matsushita T., Shigeto H., Kawamura N, et al. First diagnostic criteria for atopic myelitis with special reference to discrimination from myelitis-onset multiple sclerosis. J Neurol Sci. 2012. 316:30–35.
crossref
2.Kira J., Yamasaki K., Kawano Y., Kobayashi T. Acute myelitis associated with hyperIgEemia and atopic dermatitis. J Neurol Sci. 1997. 148:199–203.
crossref
3.Lee KJ., Baek IC., LEE JY., Kim SB., Park SM., Lim JG, et al. Characterisitcs of atopic myelitis and its relationship with toxocara canis myelitis. J Korean Neurol Assoc. 2013. 31:158–164.
4.Yoon JH., Joo IS., Li WY., Sohn SY. Clinical and laboratory characteristics of atopic myelitis: Korean experience. J Neurol Sci. 2009. 285:154–158.
crossref
5.Osoegawa M., Ochi H., Minohara M., Murai H., Umehara F., Furuya H, et al. Myelitis with atopic diathesis: a nationwide survey of 79 cases in Japan. J Neurol Sci. 2003. 209:5–11.
crossref
6.Kempster PA., Rollinson RD. The Lhermitte phenomenon: variant forms and their significance. J Clin Neurosci. 2008. 15:379–381.
crossref
7.Gemici C. Lhermitte’s sign: Review with special emphasis in oncology practice. Crit Rev Oncol Hematol. 2010. 74:79–86.
crossref
8.Al-Araji AH., Oger J. Reappraisal of Lhermitte’s sign in multiple sclerosis. Mult Scler. 2005. 11:398–402.
crossref

Figure 1.
Cervical MRI findings. Initial image (A) showed focal high signal intensity at C3-4 level in T2-weighted image. Follow-up scans after 3 months demonstrate new lesion at C4-5 level in sagittal T2-weighted (B) and axial multiplanar gradient echo sequence (D) with a subtle enhancement in gadolinium-enhanced T1-weighted (C) image and original signal disappeared. Arrow indicates each lesion.
kjcn-15-68f1.tif
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