Head and neck tumours: Lhermitte sign after radiotherapy: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: Lhermitte sign after radiotherapy

Sample item

Four months after radiotherapy for nasopharyngeal carcinoma, a patient reports electric shock sensations down the spine on neck flexion. What is this and what is the course?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Radiation myelopathy, a transient Lhermitte phenomenon that usually resolves

Early delayed radiation myelopathy presents with Lhermitte's sign, 2 to 4 months after treatment, from transient demyelination of the cervical cord. It usually resolves without treatment in 3 to 6 months. Late progressive myelopathy is a separate, irreversible complication.

Option by option

  • A. Permanent paraplegia

    The transient form does not progress to paraplegia.

  • B. Meningitis

    Meningitis causes fever and neck stiffness.

  • C. Radiation myelopathy, a transient Lhermitte phenomenon that usually resolves (correct)

    Correct. The early form is transient.

  • D. Spinal metastasis

    Metastasis would give persistent progressive deficits.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Radiation myelopathy, a transient Lhermitte phenomenon that usually resolves. Early delayed radiation myelopathy presents with Lhermitte's sign, 2 to 4 months after treatment, from transient demyelination of the cervical cord.

Why is "Permanent paraplegia" not the answer?

The transient form does not progress to paraplegia.

Why is "Meningitis" not the answer?

Meningitis causes fever and neck stiffness.

Why is "Spinal metastasis" not the answer?

Metastasis would give persistent progressive deficits.

What concept does this question test?

It tests Head and neck tumours: Lhermitte sign after radiotherapy in ENT. It usually resolves without treatment in 3 to 6 months. Late progressive myelopathy is a separate, irreversible complication.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: Lhermitte sign after radiotherapy?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.