Meningism refers to a classical constellation of symptoms and signs associated with irritation of the meninges. It is most commonly associated with bacterial meningitis but can also be attributed to intracranial hemorrhage and raised intracranial pressure, or other pathologies .

Clinical presentation

Symptoms and signs include :

  • nuchal rigidity or neck stiffness
    • an inability to passively or actively flex the neck due to muscle spasm
    • if range of motion is limited due to pain only it is not considered true nuchal rigidity
  • photophobia
    • discomfort and/or worsening of present headaches when looking into light
  • fever
  • nausea and/or vomiting
  • Kernig sign
    • resistance and pain on passive knee extension when the hip is in a flexed position
  • Brudziński signs
    • Brudziński nape of neck sign (often referred to as 'Brudziński sign'): spontaneous flexion of the hips after passive flexion of the neck
    • Brudziński cheek sign: spontaneous flexion of the arm and forearm when pressure is placed the both cheeks inferior to the zygomatic arch
    • Brudziński symphyseal sign: spontaneous hip and knee flexion, and abduction of the leg, when pressure applied to the pubic symphysis
    • Brudziński reflex: passive flexion of one knee results in reflex flexion of the contralateral hip and knee

History and etymology

Kernig sign is named after Russian-German neurologist Vladimir Mikhailovich Kernig (1840-1917), while Brudziński signs are named after a Polish pediatrician Josef Brudziński (1874-1917) .