The following symptoms and complaints may indicate Meningismus (painful neck stiffness):
Leading Symptoms
- Painfulness of head movements in the cervical spine.
- Increased resistance to passive head movements in the cervical spine
In the broadest sense, all painful symptoms that may occur due to meningitis are called meningismus.Pseudomeningismus exists when there is painfulness of movements in the neck, for example, due to a degenerative disease of the cervical spine. In such cases it is better to speak of “neck flexion pain“.
To the meningeal irritation syndrome belong in addition:
- Nausea (nausea) to vomiting,
- Sensitivity to light (photophobia).
- Sensitivity to sound (phonophobia).
The following neurological signs are prominent:
Brudzinski’s sign
- This is “positive” when the patient spontaneously flexes hip/knee joints in the supine position during passive neck movement.
Kernig sign
- This is “positive” if in the patient in the supine position, the attempt to extend the leg from the posture bent on the abdomen leads to pain.
Lasègue sign
- This is “positive” when flexion of about 70-80° is not feasible due to pain in the leg, buttocks or back occurring beforehand. Some authors evaluate the Lasègue sign as positive already when the pain symptomatology starts at a flexion of 45° (reason: tension states in the area of the back muscles can lead to a false positive test result beyond 45° (“pseudo-Lasègue).
