Irritation of the meninges
The meninges are innervated by sensitive nerves and are therefore sensitive to pain. For this reason, an irritation of the meninges can trigger symptoms such as headaches. Irritation of the meninges can have various causes: For example, sunstroke alone can cause irritation of the meninges.
However, viral infections are often the cause of such irritation. Bacteria or fungi can also lead to the typical symptoms. The symptoms can include headaches, painful neck stiffness, nausea, sensitivity to light and noise.
If the neck stiffness is due to an irritation of the meninges, this is called meningism. Neck stiffness is caused by the reflection of the head and is caused by the fact that when the head is bent forward, the meninges are stretched and this causes head and neck pain in the person concerned. Depending on the degree of irritation, this pain may already be present at rest.
The symptoms are similar to those of meningitis and therefore require medical clarification. In the case of neck stiffness that is not based on irritation of the meninges, e.g. in cervical spine disorders, a different therapy is required. Migraine is an important differential diagnosis, i.e. a disease that causes similar symptoms to meningitis.
Certain clinical signs and laboratory values can provide information and point to the underlying disease. Children may show atypical symptoms, e.g. hands are supported to the side when sitting, knee and hip joints remain flexed, the so-called Amos sign. The doctor checks whether the bending of the head causes pain and stiffening of the neck (menigism sign).
In children the knee kiss and tripod can be conspicuous, in adults it can be Brudzinski, Kernig and Lasegue sign. An examination of the brain water can also provide information about a possible disease. A lumbar puncture is performed for this purpose.
The duration and treatment of the meningeal irritation depends on the cause or the underlying disease. Antibiotics are used for bacterial inflammation and antiviral drugs for viral pathogens. Spatial demands in the area of the meninges, e.g. metastases, can also cause stretching and thus also lead to an irritation of the meninges. Removal of the mass is then necessary to relieve the symptoms. In general, however, pain therapy is mainly started to improve the headaches that occur.
