Lhermitte's Sign Developing after IMRT for Head and Neck Cancer.

International Journal of Otolaryngology
Dong C LimJohn M Holland

Abstract

Background. Lhermitte's sign (LS) is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT) for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

References

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Dec 1, 1980·International Journal of Radiation Oncology, Biology, Physics·J A WordH R Elson
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Oct 23, 2002·Human Brain Mapping·Stephen M Smith
Jan 1, 2005·Head & Neck·Wai-Man LeungChing-Jung Lo

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Citations

Oct 10, 2013·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·M N DumaS Kampfer
May 8, 2018·Radiation Oncology·Hannah M LaidleyNeil G Burnet

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