A review on radiogenic Lhermitte's sign

O. Ésik, Tibor Csere, Klára Stefanits, Z. Lengyel, G. Sáfrány, Katalin Vönöczky, Erzsébet Lengyel, Csaba Nemeskéri, I. Repa, L. Trón

Research output: Article

32 Citations (Scopus)

Abstract

Radiation myelopathy is a rare, but extremely serious side-effect of radiotherapy. Recovery from radiation-induced motor sequelae is rare, whereas, the regeneration of sensory losses is relatively frequent. Among the sensory radiogenic injuries of the spinal cord, Lhermitte's sign (LS) is most frequent. This review describes the clinical picture and diagnostic imaging signs of radiogenic LS. There have been only a few studies on large patient groups with radiogenic LS, demonstrating a rate of occurrence of 3.6-13%, relating mainly to mantle irradiation or the radiotherapy of head and neck tumors. These cases typically manifest themselves 3 months following radiotherapy and gradually disappear within 6 months. Only 3 LS cases have been described in the English literature with extraordinarily severe symptoms lasting for more than 1 year. MRI, a sensitive tool in the detection of demyelination, failed to reveal any pathological sign accompanying radiogenic LS. However, positron emission tomography demonstrated increased [18F]fluorodeoxyglucose accumulation and [15O]butanol perfusion, but a negligible [11C]methionine uptake in the irradiated spinal cord segments in patients with long-standing LS. These imaging data are suggestive of a close direct relationship between the regional perfusion and metabolism of the spinal cord, very much like the situation in the brain. We postulate that an altered, energy-demanding conduction along the demyelinated axons of patients with chronic radiogenic LS may explain the increased metabolism and perfusion.

Original languageEnglish
Pages (from-to)115-120
Number of pages6
JournalPathology and Oncology Research
Volume9
Issue number2
Publication statusPublished - 2003

Fingerprint

Radiotherapy
Perfusion
Spinal Cord
Radiation
Literature
Butanols
Spinal Cord Diseases
Fluorodeoxyglucose F18
Demyelinating Diseases
Diagnostic Imaging
Spinal Cord Injuries
Methionine
Positron-Emission Tomography
Axons
Regeneration
Neck
Head
Brain
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pathology and Forensic Medicine

Cite this

A review on radiogenic Lhermitte's sign. / Ésik, O.; Csere, Tibor; Stefanits, Klára; Lengyel, Z.; Sáfrány, G.; Vönöczky, Katalin; Lengyel, Erzsébet; Nemeskéri, Csaba; Repa, I.; Trón, L.

In: Pathology and Oncology Research, Vol. 9, No. 2, 2003, p. 115-120.

Research output: Article

Ésik, O, Csere, T, Stefanits, K, Lengyel, Z, Sáfrány, G, Vönöczky, K, Lengyel, E, Nemeskéri, C, Repa, I & Trón, L 2003, 'A review on radiogenic Lhermitte's sign', Pathology and Oncology Research, vol. 9, no. 2, pp. 115-120.
Ésik, O. ; Csere, Tibor ; Stefanits, Klára ; Lengyel, Z. ; Sáfrány, G. ; Vönöczky, Katalin ; Lengyel, Erzsébet ; Nemeskéri, Csaba ; Repa, I. ; Trón, L. / A review on radiogenic Lhermitte's sign. In: Pathology and Oncology Research. 2003 ; Vol. 9, No. 2. pp. 115-120.
@article{c07046342fce46eaab6d13f311ae0908,
title = "A review on radiogenic Lhermitte's sign",
abstract = "Radiation myelopathy is a rare, but extremely serious side-effect of radiotherapy. Recovery from radiation-induced motor sequelae is rare, whereas, the regeneration of sensory losses is relatively frequent. Among the sensory radiogenic injuries of the spinal cord, Lhermitte's sign (LS) is most frequent. This review describes the clinical picture and diagnostic imaging signs of radiogenic LS. There have been only a few studies on large patient groups with radiogenic LS, demonstrating a rate of occurrence of 3.6-13{\%}, relating mainly to mantle irradiation or the radiotherapy of head and neck tumors. These cases typically manifest themselves 3 months following radiotherapy and gradually disappear within 6 months. Only 3 LS cases have been described in the English literature with extraordinarily severe symptoms lasting for more than 1 year. MRI, a sensitive tool in the detection of demyelination, failed to reveal any pathological sign accompanying radiogenic LS. However, positron emission tomography demonstrated increased [18F]fluorodeoxyglucose accumulation and [15O]butanol perfusion, but a negligible [11C]methionine uptake in the irradiated spinal cord segments in patients with long-standing LS. These imaging data are suggestive of a close direct relationship between the regional perfusion and metabolism of the spinal cord, very much like the situation in the brain. We postulate that an altered, energy-demanding conduction along the demyelinated axons of patients with chronic radiogenic LS may explain the increased metabolism and perfusion.",
keywords = "[C]methionine, [O]butanol, [F]fluorodeoxyglucose, Magnetic resonance imaging, Permanent Lhermitte's sign, Positron emission tomography, Radiation myelopathy",
author = "O. {\'E}sik and Tibor Csere and Kl{\'a}ra Stefanits and Z. Lengyel and G. S{\'a}fr{\'a}ny and Katalin V{\"o}n{\"o}czky and Erzs{\'e}bet Lengyel and Csaba Nemesk{\'e}ri and I. Repa and L. Tr{\'o}n",
year = "2003",
language = "English",
volume = "9",
pages = "115--120",
journal = "Pathology and Oncology Research",
issn = "1219-4956",
publisher = "Springer Netherlands",
number = "2",

}

TY - JOUR

T1 - A review on radiogenic Lhermitte's sign

AU - Ésik, O.

AU - Csere, Tibor

AU - Stefanits, Klára

AU - Lengyel, Z.

AU - Sáfrány, G.

AU - Vönöczky, Katalin

AU - Lengyel, Erzsébet

AU - Nemeskéri, Csaba

AU - Repa, I.

AU - Trón, L.

PY - 2003

Y1 - 2003

N2 - Radiation myelopathy is a rare, but extremely serious side-effect of radiotherapy. Recovery from radiation-induced motor sequelae is rare, whereas, the regeneration of sensory losses is relatively frequent. Among the sensory radiogenic injuries of the spinal cord, Lhermitte's sign (LS) is most frequent. This review describes the clinical picture and diagnostic imaging signs of radiogenic LS. There have been only a few studies on large patient groups with radiogenic LS, demonstrating a rate of occurrence of 3.6-13%, relating mainly to mantle irradiation or the radiotherapy of head and neck tumors. These cases typically manifest themselves 3 months following radiotherapy and gradually disappear within 6 months. Only 3 LS cases have been described in the English literature with extraordinarily severe symptoms lasting for more than 1 year. MRI, a sensitive tool in the detection of demyelination, failed to reveal any pathological sign accompanying radiogenic LS. However, positron emission tomography demonstrated increased [18F]fluorodeoxyglucose accumulation and [15O]butanol perfusion, but a negligible [11C]methionine uptake in the irradiated spinal cord segments in patients with long-standing LS. These imaging data are suggestive of a close direct relationship between the regional perfusion and metabolism of the spinal cord, very much like the situation in the brain. We postulate that an altered, energy-demanding conduction along the demyelinated axons of patients with chronic radiogenic LS may explain the increased metabolism and perfusion.

AB - Radiation myelopathy is a rare, but extremely serious side-effect of radiotherapy. Recovery from radiation-induced motor sequelae is rare, whereas, the regeneration of sensory losses is relatively frequent. Among the sensory radiogenic injuries of the spinal cord, Lhermitte's sign (LS) is most frequent. This review describes the clinical picture and diagnostic imaging signs of radiogenic LS. There have been only a few studies on large patient groups with radiogenic LS, demonstrating a rate of occurrence of 3.6-13%, relating mainly to mantle irradiation or the radiotherapy of head and neck tumors. These cases typically manifest themselves 3 months following radiotherapy and gradually disappear within 6 months. Only 3 LS cases have been described in the English literature with extraordinarily severe symptoms lasting for more than 1 year. MRI, a sensitive tool in the detection of demyelination, failed to reveal any pathological sign accompanying radiogenic LS. However, positron emission tomography demonstrated increased [18F]fluorodeoxyglucose accumulation and [15O]butanol perfusion, but a negligible [11C]methionine uptake in the irradiated spinal cord segments in patients with long-standing LS. These imaging data are suggestive of a close direct relationship between the regional perfusion and metabolism of the spinal cord, very much like the situation in the brain. We postulate that an altered, energy-demanding conduction along the demyelinated axons of patients with chronic radiogenic LS may explain the increased metabolism and perfusion.

KW - [C]methionine

KW - [O]butanol

KW - [F]fluorodeoxyglucose

KW - Magnetic resonance imaging

KW - Permanent Lhermitte's sign

KW - Positron emission tomography

KW - Radiation myelopathy

UR - http://www.scopus.com/inward/record.url?scp=10744233699&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744233699&partnerID=8YFLogxK

M3 - Article

C2 - 12858217

AN - SCOPUS:10744233699

VL - 9

SP - 115

EP - 120

JO - Pathology and Oncology Research

JF - Pathology and Oncology Research

SN - 1219-4956

IS - 2

ER -