Diagnosis
In order to find a diagnosis, the physician performs a number of functional tests if there is a suspicion of meningitis. If these tests are “positive”, i.e. if the patient reacts to them with a certain movement, this indicates that irritation exists. When checking the Brudzinski sign, the patient lies on his back and the doctor moves his head towards the chest.
If the reaction is positive, the patient bends the knee or hip joint to escape the pain. This is because the flexion relaxes the spinal cords and thus the tension on the meninges is reduced.The Kernig sign is positive if the patient cannot stretch the bent leg in the supine position or feels severe pain. The Laségue sign is considered conspicuous if the patient cannot bend the hip by about 70 to 80° due to pain.
If the physician detects meningeal irritation, it is important to determine the cause. This is done by means of blood tests and imaging procedures such as magnetic resonance imaging (MRI) or computer tomography (CT). A lumbar puncture to examine the cerebral fluid may also be necessary.
Treatment
Depending on what is the cause of the meningitis, the treatment is different. If bacteria or other pathogens can be found, antibiotic therapy must be initiated. In these cases it is usually meningitis.
In most cases, care in the intensive care unit is necessary, as the disease can take a serious course. If there is a hemorrhage of the brain, there is an urgent need for action. Usually, surgery is necessary to stop the bleeding and relieve the pressure on the meninges.
If there is existing damage to the cervical spine, which is the cause of the meningeal irritation, appropriate measures must be taken to remedy it. Physiotherapy and medication for the pain are often the treatment approach. Physiotherapy should also be taken in cases of severe cervical disc herniations with meningitis, and in the worst case, surgery may be necessary.
