Spine: Lhermitte sign: practice question

A Orthopaedics 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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Orthopaedics · Spine: Lhermitte sign

Sample item

A 50-year-old has neck pain and an electric-shock sensation passing down the spine and into the limbs on flexing the neck, with brisk reflexes in both legs. The sign points to a lesion at which site?

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

The answer and the reasoning

D. Cervical spinal cord

Lhermitte sign is a shock-like sensation on neck flexion caused by stretch of a diseased dorsal column or cervical cord. It occurs in cervical spondylotic myelopathy and in multiple sclerosis. With brisk lower-limb reflexes it supports a myelopathy needing MRI.

Option by option

  • A. Lumbar nerve root

    A lumbar root lesion produces radicular leg pain on straight leg raising, not neck-flexion shocks.

  • B. Brachial plexus in the thoracic outlet

    Thoracic outlet compression gives arm symptoms on abduction and not shocks down the spine.

  • C. Median nerve at the wrist

    Median nerve compression causes tingling in the hand that is provoked by wrist flexion.

  • D. Cervical spinal cord (correct)

    Correct. Shock-like sensations on neck flexion, with long tract signs, indicate cord pathology in the cervical region.

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.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is D, Cervical spinal cord. Lhermitte sign is a shock-like sensation on neck flexion caused by stretch of a diseased dorsal column or cervical cord.

Why is "Lumbar nerve root" not the answer?

A lumbar root lesion produces radicular leg pain on straight leg raising, not neck-flexion shocks.

Why is "Brachial plexus in the thoracic outlet" not the answer?

Thoracic outlet compression gives arm symptoms on abduction and not shocks down the spine.

Why is "Median nerve at the wrist" not the answer?

Median nerve compression causes tingling in the hand that is provoked by wrist flexion.

What concept does this question test?

It tests Spine: Lhermitte sign in Orthopaedics. It occurs in cervical spondylotic myelopathy and in multiple sclerosis. With brisk lower-limb reflexes it supports a myelopathy needing MRI.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Spine: Lhermitte sign?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics 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.