Meningism, also called meningismus is a set of symptoms caused by irritation of the meninges. This may be due to meningitis (inflammation of the meninges), or subarachnoid haemorrhage. Meningism involves the triad (3-symptom syndrome) of nuchal rigidity (neck stiffness), photophobia (intolerance of bright light), and headache. It requires differentiating from other problems with similar symptoms, including Parkinson's Disease and Cervical Spondylosis. Related clinical signs include Kernig's sign and three signs all named Brudzinski's sign.
Video Meningism
Signs and symptoms
The main clinical signs that indicate meningism are nuchal rigidity, Kernig's sign and Brudzinski's signs. None of the signs are particularly sensitive; in adults with meningitis, nuchal rigidity was present in 30% and Kernig's or Brudzinski's sign only in 5%.
Nuchal rigidity
Nuchal rigidity is the inability to flex the neck forward due to rigidity of the neck muscles; if flexion of the neck is painful but full range of motion is present, nuchal rigidity is absent.
Kernig's sign
Kernig's sign (after Waldemar Kernig (1840-1917), a Russian neurologist) is positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance). This may indicate subarachnoid hemorrhage or meningitis. Patients may also show opisthotonus--spasm of the whole body that leads to legs and head being bent back and body bowed forward.
Brudzinski's signs
Jozef Brudzinski (1874-1917), a Polish pediatrician, is credited with several signs in meningitis. The most commonly used sign (Brudzinski's neck sign) is positive when the forced flexion of the neck elicits a reflex flexion of the hips, with the patient lying supine.
Other signs attributed to Brudzinski:
- The symphyseal sign, in which pressure on the pubic symphysis leads to abduction of the leg and reflexive hip and knee flexion.
- The cheek sign, in which pressure on the cheek below the zygoma leads to rising and flexion in the forearm.
- Brudzinski's reflex, in which passive flexion of one knee into the abdomen leads to involuntary flexion in the opposite leg, and stretching of a limb that was flexed leads to contralateral extension.
Maps Meningism
See also
- Meningitis
- Meningoencephalitis
References
External links
- FPnotebook page on meningeal signs
- Image of Kernig's sign
Source of the article : Wikipedia
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