Meningism

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Meningism
Classification and external resources
Specialty Lua error in Module:Wikidata at line 446: attempt to index field 'wikibase' (a nil value).
ICD-10 R29.1
ICD-9-CM 781.6
DiseasesDB 29490
Patient UK Meningism
MeSH D008580
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Meningism is the triad of nuchal rigidity (neck stiffness), photophobia (intolerance of bright light) and headache. It is a sign of irritation of the meninges, such as seen in meningitis, subarachnoid hemorrhages and various other diseases. "Meningismus" is the term used when the above listed symptoms are present without actual infection or inflammation; usually it is seen in concordance with other acute illnesses in the pediatric population.[1] Related clinical signs include Kernig's sign and three signs all named Brudzinski's sign.

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%.[2]

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.[citation needed]

Kernig's sign

Kernig's sign (after Waldemar Kernig (1840–1917), a Baltic German neurologist) is positive when the thigh is bent at the hip and knee at 90 degree angles, and subsequent extension in the knee is painful (leading to resistance).[3] This may indicate subarachnoid hemorrhage or meningitis.[4] Patients may also show opisthotonus—spasm of the whole body that leads to legs and head being bent back and body bowed forward.[citation needed]

Brudzinski's signs

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Jozef Brudzinski (1874–1917), a Polish pediatrician, is credited with several signs in meningitis. The most commonly used sign (Brudzinski's neck sign) is the appearance of involuntary lifting of the legs when lifting a patient's head off the examining couch, with the patient lying supine.[2][5]

Other signs attributed to Brudzinski:[6]

  • The symphyseal sign, in which pressure on the pubic symphysis leads to abduction of the leg and reflexive hip and knee flexion.[7]
  • The cheek sign, in which pressure on the cheek below the zygoma leads to rising and flexion in the forearm.[7]
  • 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.[8]

See also

References

  1. ICD9Data.com - Diagnosis Codes, Meningismus
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  6. doctor/2299 at Who Named It?
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External links