A 31-year-old woman with multiple sclerosis presents with electric shock-like pain radiating down her spine triggered by neck flexion. Vital signs: BP 118/76, HR 82, RR 16, Temp 37°C, SpO2 98%. Physical examination reproduces symptoms with neck flexion; neurologic exam otherwise intact. Cervical spine MRI shows no acute demyelinating lesions. CSF oligoclonal bands are positive. Which of the following best explains her current symptoms?
- A)Spinal cord syrinx
- B)Lhermitte sign from demyelinationGABARITO
- C)Herniated cervical disk
- D)Cervical spondylosis
- E)Posterior column myelitis
Explicação
Lhermitte sign is an electric shock-like sensation down the spine triggered by neck flexion, caused by demyelination in the dorsal columns or lateral corticospinal tract. It is a common symptom in MS despite normal imaging and indicates demyelinating pathology... Ver explicação completa e trilha adaptativa →