Learn all about meningismus symptoms, causes, signs, test and treatment.
Meningism, also called meningismus or pseudo meningitis is a set of symptoms similar to those of meningitis but not caused by meningitis.
Other symptoms can also include visual blurring, tinnitus (ringing or buzzing sound in the ears) and vertigo. Meningismus refers to these symptoms occurring without infection or inflammation of the meninges.
Meningismus, in general, comes with a positive prognosis. Most patients, including young children, will recover from the underlying cause and get better. For the best results, immediate treatment is recommended above all else.
Individuals displaying symptoms of this syndrome should be taken to the hospital as soon as possible. In most cases, a lumbar puncture gives fast therapeutic effect.
What is Meningismus Symptoms?
The meninges consist of three layers which cover the brain and spinal cord that are sensitive to pain, and any condition causing irritation or stretching of these layers will result in the characteristic symptoms of nausea, headache, neck stiffness and light sensitivity.
Meningismus Symptoms Causes
The cause of meningism can be increased intracranial pressure, brain edema (with traumatic brain injury, coma, and uremia). In infectious diseases phenomenon meningism depend on toxic irritation of the meninges. It should treat the underlying disease. Meningismus can result from infection (usually influenza, pneumonia, measles, scarlet fever, typhus and typhoid fever), poisoning (coma, diabetes, uremia, food poisoning, and occupational poisoning), brain injury after a lumbar puncture endolumbalno introduction of medicinal substances, with hypertension and others.
Meningismus Symptoms Signs
Meningismus is characterized by the signs and symptoms of nuchal rigidity (neck stiffness), photophobia (sensitivity to bright light), and headache. Other symptoms include headache, stiff neck, vomiting, and dizziness. Other related clinical signs include Kernig’s sign and Brudzinski’s sign. Nuchal rigidity is the inability to perform the neck flexion forward due to rigidity of neck muscles. In case if flexion of the neck is painful but achievable, and complete range of neck motion is present, nuchal rigidity is said to be absent. Kernig’s sign is said to be positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent knee extension is painful (giving rise to resistance). Patients may also display features of opisthotonus in which the whole body undergoes spasm that leads to bending back of the legs and head and bowing forward of the body.
Brudzinski’s neck sign is positive when the patient, while lying supine, involuntarily lifts the legs when examiner attempts to lift the patient’s head off the examining couch. Meningismus may also be associated with positive symphyseal sign, in which exertion of pressure on the pubic symphysis gives rise to abduction of the leg and reflexive flexion of the hip and knee joint. The cheek sign may be present, in which exertion of pressure on the cheek below the zygoma may lead to forearm rising and flexion. Brudzinski’s reflex may also be seen in meningismus, in which passive flexion of one knee into the abdomen leads to involuntary flexion of the knee in the opposite leg also, and stretching of a limb that was previously flexed leads to extension in the opposite side also. Many persons may display neurocognitive symptoms, such as fatigue, mood disturbances, memory disturbance, and other related symptoms.
Meningismus Symptoms Test
Meningismus symptoms test include the Kernig’s Sign and Brudzinski’s Sign.
- In Kernig’s Sign, the patient is supine with the knee bent at right angles. As the leg as straightened, it causes leg pain.
- In Brudzinski’s Sign, when the neck is flexed, it causes flexion of the hips and knees.
- These tests have good specificity, but poor sensitivity. The JOLT test is potentially helpful in determining which patients with fever and headache need a lumbar puncture.
A prospective study in March 1991 looked at 54 patients with fever and a headache.
The results of this study were suggested that if there is a JOLT +ve and fever and headache, even if no neck stiffness, the patient needed a lumbar puncture.
Meningismus Symptoms Treatment
Meningismus symptoms treatment depends on the underlying cause. Meningismus is a very treatable syndrome with a positive outlook. Doctors often treat the underlying causes of the disease and focus on reducing intracranial pressure. Typically, a lumbar puncture is performed to great effect. An infusion of hypertonic solutions is often recommended to reduce swelling in the brain or meninges. Various medicines and surgeries can be utilized to reduce the effects of the syndrome.
For many patients, a battery of antibiotics will work wonders for their condition. In most cases, doctors can treat the underlying cause of meningismus and cure patients of their afflictions. More severe cases of meningismus (and the underlying cause) can be dangerous for patients, though. Swift identification of the root cause and immediate treatment of the symptoms is the best course of action to ensure patient safety. Otherwise, an untreated bout of meningismus means the underlying cause is worsening and becoming more severe. Due to the presence of phenomena edema and swelling of the brain and its meninges recommended intravenous infusion of hypertonic solutions, intramuscularly – novoryt, Mercosul, inside – 3% solution amidopirina.