Indications

L’hermitte’s sign is a cervical spine examination procedure that tests for the presence of cervical myelopathy.

Procedure

Patient should be awake and cooperative to assess for L’hermitte’s Sign.

  1. Patient should be seated or supine during the procedure.
  2. The examiner passively flexes the head forward using gentle pressure.
  3. The examiner checks for any pain while maintaining pressure over the back of the head.

Examiner applies gentle pressure on the patient’s head.

Interpretation

Positive L’hermitte’s Sign

There is a positive L’hermitte’s Sign when there is sharp pain characterized by pain shooting down the spine or extremities. This sign could indicate the presence of cervical myelopathy.

Clinical Notes

There are many causes of cervical myelopathy: cord tumor, posterior column disease, meningeal adhesions or irritation, multiple sclerosis, stenosis, stenosis or disc herniation are just some of the very common causes.