METHODS: A systematic review was conducted using PubMed, EMBASE, and the Cochrane Library from inception to August 2022 for peer-reviewed articles describing the treatment of patients with Lhermitte\'s phenomenon. The review adheres to the PRISMA guidelines and was registered on PROSPERO.
RESULTS: This systematic review included sixty-six articles, which included 450 patients with LP. Treatment of the underlying cause varied by aetiology. Whilst LP is most commonly considered in the context of structural pathology of the cervical cord, medication-induced LP was a common theme in the literature. The most common cause of medication-induced LP was platinum-based chemotherapy agents such as cisplatin and oxaliplatin. In medication-induced LP, symptoms typically resolved with cessation of the causative agent. Non-pharmacological treatment options were associated with mild-moderate symptomatic improvement. The most commonly used agents to treat patients with LP were carbamazepine and gabapentin, which resulted in variable degrees of symptomatic benefit.
CONCLUSIONS: No randomised studies currently exist to support the use of symptomatic therapies to treat LP. Observational data suggest that some therapies may yield a symptomatic benefit in the management of LP. However, this systematic review identified a significant paucity of evidence in the literature, which suggests that further controlled studies are needed to investigate the optimal management of this common neurologic phenomenon.
方法:使用PubMed进行了系统评价,EMBASE,和Cochrane图书馆从成立到2022年8月的同行评审文章,描述了Lhermitte现象患者的治疗。该审查符合PRISMA指南,并在PROSPERO上注册。
结果:本系统综述包括66篇文章,其中包括450名LP患者。根本原因的治疗因病因而异。虽然LP最常被认为是在颈髓的结构病理学的背景下,药物诱导的LP是文献中的共同主题。药物诱导的LP的最常见原因是基于铂的化疗药物,例如顺铂和奥沙利铂。在药物诱导的LP中,症状通常随着病原体的停止而解决。非药物治疗方案与轻度-中度症状改善相关。治疗LP患者最常用的药物是卡马西平和加巴喷丁,这导致了不同程度的症状获益。
结论:目前尚无支持使用对症疗法治疗LP的随机研究。观察数据表明,某些疗法可能会在LP的管理中产生症状性益处。然而,这篇系统的综述发现了文献中大量缺乏证据,这表明需要进一步的对照研究来研究这种常见神经系统现象的最佳管理。