What are the meningeal signs?

Meningism—a clinical syndrome of signs and symptoms that are suggestive of meningeal irritation. Symptoms may include headache, photophobia, neck stiffness and seizures. Signs may include nuchal rigidity, Kernig’s sign, Brudzinski’s sign or jolt accentuation headache.

What are the signs of meningeal irritation in pediatrics?

Meningeal irritation, as assessed by the pediatrician in the ED, was defined as presence of one or more of the following six symptoms: neck stiffness, Brudzinski’s nape of the neck and/or contralateral leg sign, Kernig’s sign, or the tripod-phenomenon in children >1 year and one of the previous signs or irritability or …

What meningeal sign is typical for infants?

In young infants, paradoxic irritability is the usual sign of meningeal irritation – the infant prefers to remain motionless and becomes markedly irritable when handeled.

When are meningeal signs present?

Meningeal signs Kernig sign is present if the patient, in the supine position with the hip and knee flexed at 90º, cannot extend the knee more than 135º and/or there is flexion of the opposite knee.

What is meningeal syndrome?

Meningism is the clinical syndrome of headache, neck stiffness, and photophobia, often with nausea and vomiting. 1. It is most often caused by inflammation of the meninges (see later), but other causes include raised intracranial pressure.

What are the cardinal signs of meningitis?


  • Sudden high fever.
  • Stiff neck.
  • Severe headache that seems different from normal.
  • Headache with nausea or vomiting.
  • Confusion or difficulty concentrating.
  • Seizures.
  • Sleepiness or difficulty waking.
  • Sensitivity to light.

Which sign of meningeal irritation occur in a child diagnosed with bacterial meningitis?

The following symptoms are readily recognized as associated with meningitis in infants and children: Nuchal rigidity. Opisthotonos. Bulging fontanelle.

What is the test for meningitis?

Spinal tap (lumbar puncture). For a definitive diagnosis of meningitis, you’ll need a spinal tap to collect cerebrospinal fluid (CSF). In people with meningitis, the CSF often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein.

How do you rule out meningitis in children?

How is meningitis diagnosed in a child?

  1. Lumbar puncture (spinal tap). This is the only test that diagnoses meningitis.
  2. Blood tests. These can help diagnose infections that cause meningitis.
  3. CT scan or MRI. These are tests that show images of the brain.
  4. Nasal, throat, or rectal swabs.

How to tell if your child has meningitis?

Instead, babies may be slow or inactive, irritable, vomiting, feeding poorly, or have a bulging in the soft spot of the skull (anterior fontanelle). In young children, doctors may also look at the child’s reflexes for signs of meningitis. If you or your child has any of these symptoms, call the doctor right away.

How is the diagnostic accuracy of Meningeal signs determined?

The diagnostic accuracy of the ‘classic meningeal signs’ in children with suspected bacterial meningitis To prospectively determine the diagnostic accuracy of nuchal rigidity, Kernig’s sign, and Brudzinski’s sign in children with suspected bacterial meningitis.

Can a 1 year old have bacterial meningitis?

Bacterial meningitis is uncommon in children over the age of 1 year. Meningitis can be difficult to detect clinically. The absence of Kernig’s sign, Brudzinski’s sign and nuchal rigidity is reassuring in low-risk settings but cannot fully exclude meningitis.

What does absence of clinical signs of meningitis mean?

In summary, absence of clinical signs of meningitis suggests a very low risk of meningitis assuming a low pretest probability. The absence of clinical signs is reassuring in low-risk children, but meningitis can occur without clinical signs of meningism.