Meningism

Meningism is a painful neck stiffness, which occurs especially in meningitis. Read more about it!

Meningism

Under meningism one understands a painful neck stiffness, which occurs above all with illnesses of the meninges. Those affected can no longer actively bend their head to the chest, because pain and tension in the neck muscles prevent this. In a broader sense, meningism also includes other complaints such as nausea and photophobia. Read here, which can lead to meningism and why you need to go to the doctor immediately.

Product Overview

meningism

  • description

  • Causes and possible diseases

  • When do you have to go to the doctor?

  • What does the doctor?

Meningism: description

Patients with meningitis have head and neck pain when trying to bend their head towards the sternum. That is why they avoid this movement. In addition, the neck muscles in response to the pain, which makes the head flexion even more difficult. This gives the impression of neck stiffness, although neither the cervical vertebrae nor the neck muscles are impaired. Accordingly, the neck stiffness disappears in deep unconsciousness.

The term meningism goes back to the medical term "meninges" for meninges. The cause of pain in meningitis is usually an irritation or disease of the meninges.

The neck stiffness is then often not the only symptom. In addition, patients typically suffer from headaches, nausea and increased sensitivity to light and noise (photophobia or phonophobia). These complaints are also summarized under the name "meningeal syndrome".

How does the pain develop in meningism?

There are three meninges that overlay one another like layers and surround the entire brain and spinal cord. The inner (pia mater) and middle (arachnoid) skin are also referred to as soft meninges, the outer (dura mater) as hard meninges. They have a protective function and also play an important role in blood drainage and nutrient supply.

Especially the outer meninges are very sensitive to pain. If the meninges are irritated, she is responsible for some severe headaches. If the patient bends his head forward, this exerts a slight pull on the meninges. This intensifies an already existing pain in the head and neck area. If a disease of the meninges is still at an early stage, or if the meninges are only slightly irritated, there may (still) be no pain at rest. He is then released only when bending the head.

Meningism: causes and possible diseases

Typically, meningitis occurs in meningitis (meningitis), often as the first symptom. Triggers of such inflammation of the meninges are usually certain bacteria or viruses, more rarely fungi or parasites. Not every meningitis is necessarily accompanied by a meningitis. For example, diseased neonates often have no neck stiffness.

In addition to inflammation by pathogens, there are some other triggers that can cause irritation of the meninges and subsequently meningitis. This includes:

  • Subarachnoid haemorrhage: A type of stroke with hemorrhage between the inner and middle meninges. The main symptom is sudden, very severe headache.
  • Meningeosis neoplastica: Dislocation of tumor cells in the soft meninges; can occur in the late stages of various cancers.
  • Sinus thrombosis: Blood clots in the large blood outlets (sinuses) of the brain. These are located in the hard meninges.
  • Sepsis ("blood poisoning"): Spread of bacteria or fungi from a focal point of inflammation in the entire bloodstream and as a result of infestation of various organs (such as the meninges).
  • Sunstroke: inflammatory reaction of the meninges due to longer direct sunlight on the head and neck.
  • Lead poisoning: Possible consequences are other spasms and inflammation of the cerebral vessels (lead encephalopathy). In the course, this sometimes leads to irritation of the meninges.

Pseudomeningismus

If a painful neck stiffness is triggered not by irritated meninges, but other factors, it is called a pseudomeningism. The causes of such neck flexion pain include, for example, fractures, disc herniations or signs of wear (arthrosis) in the cervical spine. Migraines or tumors can also lead to pseudomeningism.

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Meningism: When do you need to see a doctor?

Meningism is an emergency and almost always indicates serious illness. Regardless of possible other symptoms, sufferers should therefore go as quickly as possible in an emergency room or call the ambulance.

A pseudomeningismus usually lacks additional symptoms such as nausea or photosensitivity. But they can also fail in meningism, so you should always, especially with a sudden neck stiffness to the doctor.

Diseases with this symptom

  • aneurysm
  • Lyme disease
  • cerebral hemorrhage
  • heatstroke
  • meningitis
  • sunstroke

Meningism: What does the doctor do?

If there is a suspicion of meningism, the doctor first asks the patient if there are other complaints besides the neck stiffness. If there are other causes behind the neck stiffness, there may be hints in the patient talk.

When examining, the doctor bends the patient's head forward while lying on his back. He pays attention to whether the head flexion is difficult and whether the patient indicates pain - evidence of meningitis.

There are also other signs of meningitis that the doctor can check: the so-called nerve extension signs. Through certain maneuvers, he stretches the meninges of the patient, which leads to pain. The nerve extension signs include:

  • Lasègue sign: The doctor raises the stretched leg of the supine patient. In irritated meninges, this can lead to pain in the leg, buttocks or back from a certain flexion.
  • Kernig-Zeichen: The patient is supine and has the leg bent in hip and knee joint. The doctor now slowly stretches the leg in the knee joint, with the same pain as the Lasègue sign.
  • Brudzinski sign: Again the patient lies on his back. The doctor bends his head forward, whereupon the patient reflexively puts on his legs to avoid pain.

It is called nerve extension signs, because during this test maneuver not only in a meningeal pain, but also when nerve roots on the spinal cord are irritated. The neck stiffness is missing then but usually.

Has the suspicion meningism confirmed, the cause must be found with the help of additional investigations. The faster this happens, the sooner the right therapy can be started.
Meningism

FAQ - 💬

❓ What are signs of Meningism?

👉 Meningism—a clinical syndrome of signs and symptoms that are suggestive of meningeal irritation. Symptoms may include headache, photophobia, neck stiffness and seizures. Signs may include nuchal rigidity, Kernig's sign, Brudzinski's sign or jolt accentuation headache.

❓ How is Meningismus treated?

👉 Prolonged rest in a recumbent position usually resulted in relief or complete disappearance of both headache and meningeal signs. Monitoring of the meningeal signs is helpful for evaluation of the patient's condition in the course of treatment.

❓ What is the significance of the positive Kernig's and brudzinski's signs?

👉 Although the sensitivity is quite low, the high specificity suggests that if Kernig's or Brudzinski's sign is present, there is a high likelihood for meningitis. The two signs, Kernig's and Brudzinski's, are often performed together in clinical practice.

❓ What is difference between meningitis and Meningism?

👉 Whereas meningitis is inflammation of the meninges (membranes that cover the central nervous system), meningism is caused by nonmeningitic irritation of the meninges, usually associated with acute febrile illness, especially in children and adolescents.

❓ Is Meningism the same as meningitis?

👉 Meningococcal disease refers to a condition caused by the meningococcal bacterium (or, Neisseria meningitidis). Meningococcal disease can include meningitis (inflammation of the lining of the brain and spinal cord – this lining is called the meninges), and septicaemia (blood poisoning).

❓ What causes Meningism?

👉 Meningism is the clinical syndrome of headache, neck stiffness and photophobia, often with nausea and vomiting. It is most often caused by inflammation of the meninges (see below), but other causes include raised intracranial pressure.

❓ What is a positive Kernig's?

👉 Kernig described a positive sign as the inability to extend the knees more than 135 degrees. In severe cases, patients were unable to extend the knees past 90 degrees. The maneuver was performed with the patient seated in the upright position with the hips flexed 90 degrees to the trunk.

❓ How do you test for Meningism?

👉 Spinal tap (lumbar puncture). For a definitive diagnosis of meningitis, you'll need a spinal tap to collect cerebrospinal fluid (CSF). In people with meningitis, the CSF often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein.

❓ How serious is bacterial meningitis?

👉 Bacterial meningitis is serious. Some people with the infection die and death can occur in as little as a few hours. However, most people recover from bacterial meningitis. Those who do recover can have permanent disabilities, such as brain damage, hearing loss, and learning disabilities.

❓ Is MCV4 the same as meningitis B vaccine?

👉 MPSV4 and MCV4 can prevent four types of meningococcal disease, which make up about 70% of the cases in the U.S. The MenB vaccines prevent the Meningococcal B strain. MCV4 is preferred for people age 55 and younger. The recommendation for teens is one dose at age 11 and one dose at age 16.

❓ Is MCV4 the same as meningitis vaccine?

👉 Two types of meningococcal vaccines are available in the United States. Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for those aged 2 to 55. Meningococcal polysaccharide vaccine (MPSV4) may be used if MCV4 is not available; it is also licensed for people older than 55.


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