Signs in Meningitis

Here are some of the clinical signs that are seen in meningitis. Some of them are quite common, however, some of them are quite rare...

1)Neck rigidity:

It is resistance to passive flexion of head, an early sign of meningitis..
It is d/t spasm of extensor muscles of neck..
It can be tested by asking pt to place chin upon chest, which can not be done...

2)Kernig's sign:

With pt's hip flexed, the examiner tries to extend the knee as far as possible. Normally the knee can be extended so that the angle b/w posterior surface of thigh & leg is about 135 degrees.
In positive Kernig's sign, the angle is less d/t spasm of hamstring muscles & pain arises as a result of stretching of the spinal nerve-roots of the lower limb, the lower end of the subarachnoid space of the spinal cord being distended & spinal meninges inflamed...

3)Brudzinski's signs:

a) Neck sign: Flexion of the hips & knees on flexing the neck or turning it to one side..

b) Leg sign: On flexion of one lower extremity, there is automatic flexion of the opposite lower limb..

c) Pubic sign: Flexion of both knees on pressure over symphysis pubis..

d) Chick sign: Flexion at both elbows on pressure over chick bones..

4)Lasegue's sign:

With pt lying on back & both legs fully extended at knee, the examiner passively flexes each leg at hip while keeping the knee joint extended. Normally the straight leg can be lifted to an angle(with horizontal) of 65 to 90 degrees.
In case of meningitis, this angle is reducud & pain & limitation of movements present earlier.

5)Gullian's sign:

On applying pressure or pinching over one quadriceps muscle, there is flexion of contralateral hip & knee..

6)Leichtenstern's sign:

On gentle tapping of bones of extremities, there is pain & patient may wince, draw back suddenly or cry out loudly..

7)Signorelli's sign:

There is extreme tenderness on palpation of retromandibular joint..

8)Simon's sign:

It is seen early in meningitis..
There is in-coordination of movements of the diaphragm & the thorax..

9)Bikele's sign:

With patient holding arms abducted & forearms flexed, examiner tries to extend the forearms. This is quite painful & can not be done easily in meningitis..

Category: Medicine Notes , Neurology notes