A physical therapist is evaluating a 38-year-old patient who reports an electric shock-like sensation radiating down the spine and into both arms when flexing the neck. The therapist suspects a positive Lhermitte's sign. Which of the following conditions is MOST likely associated with this clinical finding?

1. Thoracic outlet syndrome
2. Multiple sclerosis
3. Cervical radiculopathy
4. Cervical paraspinal spasm

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