Abstract
Lhermitte's sign, a classical neurological sign, is a rare manifestation of vitamin B12 deficiency. The aim here was to report on a case of an elderly patient with vitamin B12 deficiency whose first clinical manifestation was the presence of Lhermitte's sign. We describe an elderly patient with vitamin B12 deficiency who presented cognitive dysfunction, peripheral polyneuropathy and sensory ataxia, and whose first clinical manifestation was the presence of Lhermitte's sign. This sign is one of the rarest manifestations of vitamin B12 deficiency.
Highlights
Vitamin B12 deficiency is found in 15% of the geriatric population
The neurological manifestation consists of subacute combined degeneration of the spinal cord that is clinically characterized by sensory ataxia, peripheral neuropathy, cognitive dysfunction and optic neuropathy.[1,2]
To estimate the validity and frequency of this sign for diagnosing myelopathy, we conducted a systematic review of the literature, including the following databases: DotLib – OVID; DotLib – OVID (Lippincott); EBSCO Biomedical Reference Collection; EBSCO – MedicLatina; EBSCO – Medical Literature Analysis and Retrieval System Online (Medline); ProQuest - Medical Library; PubMed; Cochrane Library; and Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs)
Summary
Vitamin B12 deficiency is found in 15% of the geriatric population. The manifestations are hematological, gastrointestinal and neuropsychiatric.[1,2] The neurological manifestation consists of subacute combined degeneration of the spinal cord that is clinically characterized by sensory ataxia, peripheral neuropathy, cognitive dysfunction and optic neuropathy.[1,2]Lhermitte’s sign, known as the barber’s shop sign, is more properly a symptom than a sign, and is described by patients as an electriclike sensation induced by forward flexion of the head.[3,4] It was originally described by Marie and Chatelin in 1917, and one year later by Babinski and Dubois. Neurology Service, Department of Internal Medicine, Hospital das Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
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