ELECTRIC SHOCK-LIKE SENSATIONS IN 42 CANCER-PATIENTS - CLINICAL CHARACTERISTICS AND DISTINCT ETIOLOGIES

We retrospectively evaluated 42 consecutive cancer patients manifestin g electric shock-like sensations. Four ty three percent presented with Lhermitte's sign (LS), 24% with the previously described outstretchin g in abduction maneuver (OAM) of the arms, and 33% had both phenomena. Twenty nine patients had underlying polyneuropathy related to cisplat in-based chemotherapy in 27 and to thiamine deficiency in 2. Thirtreen patients had myelopathy which was induced by radiotherapy in 11. Pati ents with polyneuropathy manifested both LS and OAM, while patients wi th myelopathy more often presented with LS. Neurologic signs suggestiv e of spinal cord involvement were present in 3 patients with polyneuro pathy and in 7 of 11 irradiated patients. MRI disclosed cervical spina l cord swelling in 3 patients with LS. Prolonged cervical latencies on SSER were noted in 5 of 15 patients. All had LS and 3 also had OAM as sociated with abnormal latencies in the brachial plexi. We conclude th at LS and OAM are positive sensory manifestations of increased mechano sensitivity of the damaged central or peripheral sensory axons in the cervico-brachial area. In cancer patients, these phenomena largely man ifest treatment-induced myelopathy or polyneuropathy. Auxiliary studie s help to confirm diagnosis and to depict the uncommon but treatable c auses.