Meningismus (synonyms: meningeal syndrome; painful neck stiffness; ICD-10-GM R29.1: meningismus) is a pathognomonic (characterizing) symptom indicative of neurologic disease associated with irritation of the meninges (meninges of the brain). It is due to reflex tension of the neck muscles in response to pain. The affected person is no longer able to lower his chin towards his chest.
Neck stiffness is the main symptom of meningismus. Meningeal irritation syndrome also includes nausea to vomiting, as well as sensitivity to light (photophobia) and sound (phonophobia).
Other clinical signs of meningeal irritation include:
- Brudzinski’s sign* .
- Kernig sign*
- Lasègue character*
* See this under “Symptoms – Complaints”.
Pseudomeningism exists when the movements in the neck are painful, for example, due to a degenerative disease of the cervical spine. In such cases it is better to speak of “neck flexion pain“.
Meningismus can be a symptom of many diseases (see under “Differential diagnoses”).
Course and prognosis: The course and prognosis depend on the triggering cause. If meningismus occurs in the context of a febrile general infectious disease, it tends to be a (relatively) harmless concomitant symptom. In a bacterially caused form of meningitis, life-threatening complications may occur. If left untreated, a large proportion of those affected die. Meningismus occurring in the setting of pneumococcal infection also has a poor prognosis.
