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Meningeal symptoms are a group of neurological symptoms characteristic not only of encephalitis or meningitis. Meningeal symptoms can also occur in the syphilis of the nervous system and, although rarely, in the course of mumps. Check what are the meningeal symptoms and what diseases they may indicate.
Meningeal symptomsis a group of neurological symptoms caused by muscle contracture caused by irritation of nerve roots. These symptoms most often occur in encephalitis and meningitis, but they can also accompany other diseases in which the disease process takes place in the subarachnoid space, e.g. nervous system syphilis or mumps. Meningeal symptoms can also be the result of trauma and the development of intracranial tumors. It should be remembered that meningeal symptoms are one of the symptoms of the above-mentioned diseases and accompany the basic symptoms of a given disease.
Meningeal symptoms - neck stiffness
You can talk about a stiff neck when the patient cannot or has difficulty bending his head to the chest in a lying position. It is estimated that the stiffness of the neck occurs in 30%. adult patients with meningitis.
Meningeal symptoms - Brudziński symptom
- Brudziński's symptom of the neck
The neck stiffness test is performed in the supine position. One hand of the patient supports his head and the other is placed on his chest. Then the patient tries to raise his head. Brudziński's neck symptom is positive when an attempt to bend his head to the sternum is unsuccessful and causes involuntary flexion of the lower limbs in the hip and knee joints.
- Brudziński's pubic symptom
After pressure on the pubic bone (middle area of the lower abdomen), the lower limbs are bent in the knee and hip joints.
- Brudziński's symptom buccal
Pressure on the cheek below the zygomatic bone causes the forearms to rise and bend.
Research shows that Brudziński's symptom is present in approx. 5% of adult patients with meningitis.
Meningeal symptoms - Kernig symptom
- upper Kernig symptom - when the torso of a sitting patient is bent forward, there is a reflex flexion of the lower limbs in the jointsknee and lap
- Kernig's symptom lower - during passive lifting of the lower limb, there is involuntary flexion in the knee joint. Kernig's symptom is positive when the leg cannot be bent more than 135 ° at the knee joint, while flexing it at the hip joint to an angle of 90 °. Straightening the lower limbs is also impossible due to the pain it causes.
Kernig's symptom is observed in 5% of adult patients with meningitis.
Meningeal symptoms - Flatau symptom
- Upper Flatau symptom (cervical-mydriatic) - pupils dilate as a result of drawing the head to the chest
- Flatau's lower (erectile) symptom - in small boys, when the torso is tilted forward several times, a penile erection appears. This symptom is most often seen in tuberculous meningitis
Other meningeal symptoms
- Weil-Edelman symptom- when examining the Kernig (lower) symptom, the toe dorsal flexion (as in the Babinski symptom). This is a symptom of meningitis, especially with cerebral edema
- Amoss symptom- the patient, sitting on the bed, props himself on the straightened upper limbs, set to the sides and back
- Bikeles symptom- pain appears when straightening the bent forearm
- Herman's symptom(cervical-toe) - with passive bending of the head forward, the big toe is dorsally flexed. This symptom is common in tuberculous meningitis
Meningeal symptoms usually accompany the basic symptoms of a given disease, such as: headache, nausea and vomiting, photophobia, hypersensitivity to auditory stimuli, skin hyperaesthesia or general pain.