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Brain diseases are characterized by the presence of specific symptoms, the basis of which is meningeal symptoms. These symptoms are the main evidence of the onset of serious changes in the nervous system, and the sooner the disease is recognized and treatment is started, the greater the chance of recovery without serious consequences.

It is no coincidence that meningeal signs have this name, since in the vast majority of cases the cause of their manifestation is meningitis. Its different forms are characterized by certain symptoms, but the basis is meningeal.

With meningitis, in addition to inflammatory processes in the brain, noticeable changes occur in the cerebrospinal fluid, and this is one of the features of the course of the disease. There are a number of causes that can cause symptoms similar to meningeal syndromes, but do not affect the spinal cord, in particular:

• excessive sunbathing
• excessive saturation of the human body with water (usually occurs after severe dehydration)
• severe infectious diseases (salmonellosis, typhoid, influenza)
• alcohol poisoning
• transient cerebrovascular accident (TCI)
• allergies
• brain tumors
• radioactive damage to the body

All of the above can cause the development of meningeal syndrome, but in this situation the treatment differs from the treatment of meningitis.

In addition, there is such a thing as “pseudomeningeal symptoms,” which occur in some diseases that are not associated with damage to the meninges (mental disorders, osteochondrosis). That is why it is important to take into account all manifestations and make the correct diagnosis.

Classification

It's time to look directly at the symptoms themselves, which are commonly called meningeal. The meningeal symptom complex includes:

a — pointing dog pose, b — Kernig’s sign, c — Brudzinski’s sign

• Kernig's sign
• Brudzinski syndrome
• headache
• vomit
• Bekhterev's symptom
• Gordon's reflex
• Guillain's reflex
• Le Sage syndrome
• stiff neck muscles
• presence of a “pointing dog” pose
• hyperesthesia

To diagnose a syndrome such as Kernig's symptom, the patient is asked to take a supine position, after which the doctor bends his leg at the hip and knee joints at an angle of 90°. Flexion occurs unhindered, but problems arise with extension. So, due to tension in the muscles of the back of the thigh, the patient cannot do this on his own.

Brudzinski syndrome

Brudzinski meningeal syndrome has several variations, including:

1. Buccal.
2. Lower.
3. Upper.
4. Average.

Buccal – the doctor applies pressure to the patient’s cheek, resulting in involuntary flexion of the arms at the elbow joint, as well as a kind of shrug of the shoulders.

Lower - With the patient sitting, one of the legs is bent, the second automatically bends along with the first.

Upper – the patient’s head is tilted forward, and the legs are automatically bent.

Medium – when pressing on the patient’s pubis, the legs bend.

Often, Kernig and Brudzinski syndromes occur together in meningitis.

Headache

When meningitis occurs, headache accompanies the patient constantly and does not stop for a minute. It is one of the most pronounced meningeal symptoms.

Vomit

Gag reflexes can occur in a patient even in the absence of such manifestations as primary symptoms, such as nausea. Vomiting occurs suddenly against the background of a severe headache and is characterized by a gushing outpouring.

In some cases, there is a decrease in the intensity of headaches after bouts of vomiting.

Bechterew's syndrome

Meningeal ankylosing spondylitis is diagnosed by tapping the patient's cheekbone with a finger. This tapping causes a severe headache on the side of the face where there is inflammation, in addition, this side will curl up in a grimace of pain.

Gordon's meningeal syndrome is diagnosed by a neurologist as follows: the doctor wraps his hand around the patient's lower leg and applies strong compression. As a result, the patient's big toe unclenches, and the fingers also diverge in different directions.

Guillain reflex

The patient is asked to take a lying position, after which the doctor applies pressure on the front surface of the thigh of one of the legs or squeezes it. As a result, the opposite leg involuntarily bends at the knee.

Lesage syndrome

This symptom is typical for infants, and in most cases it is diagnosed in them. The patient lifts himself by the armpits above the floor, as a result of which the baby's legs involuntarily tighten (are pulled towards the chest).

Neck muscle stiffness

This condition is characterized by hypertonicity of the occipital and cervical muscles and manifests itself in the inability or difficulty in performing simple actions, such as turning the head or tilting it.

Often, muscle rigidity is characteristic of young children, but not in quality, but due to the fact that the peripheral nervous system is not fully formed. Therefore, it is extremely important to diagnose the disease comprehensively and be based on several factors.

Pointing dog pose

In some sources there is such a name as the “cocked hammer” pose. It manifests itself as follows: the patient throws his head back, the torso is tense and elongated, the arms are pressed tightly to the chest, the legs are also pulled up to the thoracic region.

Hyperesthesia

Meningeal hyperesthesia syndrome, or increased light and noise sensitivity, manifests itself in the form of painful perception by the patient of bright light and loud sounds. For this reason, the patient is recommended to stay in a darkened room and, if possible, completely eliminate irritating sounds.

Features of the course of the disease in children

As for children, at an early age it is difficult to diagnose the disease based on meningeal symptoms, since most of them do not appear.

The main symptom characteristic of children is Le Sage syndrome, as well as a severe headache, against the background of which the child becomes irritable, refuses to eat and develops apathy.

Rare species

Modern neurology, in addition to the above, there are other meningeal syndromes, however, their manifestations are rare, these include:

1. Levinson's sign (opening of the mouth when trying to touch the chin to the chest).
2. Perrault's sign (pupil dilation with any pain).
3. Mendel's sign (pressure on the eyeballs or ears causes pain).

Thus, as soon as meningeal syndrome manifests itself in a patient, the patient must immediately take measures to contact a specialist and begin treatment as soon as possible, since in addition to mild forms of meningitis, there is a possibility of developing acute forms of meningitis, which can be fatal.

When the meninges and spinal roots are irritated, meningeal symptoms occur, which are observed in various diseases of the brain and spinal cord:

Meningeal pose "gun trigger pose"- Position the patient with his head thrown back, his torso straightened and his legs pulled up to his stomach.

Kernig's simpom– For the patient lying on his back, the leg is bent at the hip and knee joints at a right angle, and then it is extended at the knee joint. The symptom is considered positive if the leg cannot be straightened at the knee joint due to sharp resistance of the leg flexors and pain reaction.

Stiff neck– Position the patient on his back by actively or passively bending the head to the chest. If there is rigidity in the muscles of the back of the head, the patient's chin does not reach the chest and a pain reaction occurs.

Upper Brudzinski's sign– Determination of stiffness of the neck muscles causes involuntary flexion of the legs at the hip and knee joints.

Brudzinski's sign is moderate– When pressing on the pubic area, bending of the legs at the knee and hip joints is observed.

Brudzinski's sign lower– When passively flexing one leg at the hip joint and extending it at the knee joint, involuntary flexion of the other leg occurs.

Lessage's sign (suspension)– They take the child under the arms and lift him up, while his legs involuntarily pull up to his stomach.

Bechterew's sign (zygomatic)– When percussing with a hammer on the zygomatic arch, a contraction of the zygomatic muscles and an involuntary grimace of pain occurs.

Guillain's sign– Compression of the quadriceps femoris muscle on one side leads to involuntary flexion of the other leg at the knee and hip joints.

22. The most commonly identified symptoms of brucellosis

Ankylosing spondylitis – lumbosacral radiculitis. Pain in the popliteal fossa when straightening the leg, bent at the knee joint.

Or - a sign of damage to the sacroiliac joint. If a patient lying on his stomach bends his leg at the knee joint so that the shin is in contact with the thighs, then the pelvis rises and comes off the table.

Lage is a sign of pathology of the sacroiliac joint. Pressure on the heel of an extended, abducted and outwardly rotated leg causes pain in the patient.

Larrea – pain in the sciatic nerve, sacrum, when moving from a lying position to a sitting position.

Kushelevsky - A) pressure from the palms on the crests of the iliac bones with the patient in the lateral position causes sharp pain in the area of ​​both sacroiliac joints. B) Stretching the pelvis with the fingers of both hands, fixed on the crests of both iliac bones, significantly increases the intensity of pain in the joints.

Makarova is a sign of sacroiliitis. The appearance of pain when tapping with a hammer in the area of ​​the sacroiliac joints.

Minor’s “sit up” – when trying to sit up in bed with legs outstretched, when trying to bend the torso, a reflex flexion occurs in the knee joint of one or both legs.

Opokina (sm “ripe watermelon”, sm “symphysitis”) – A) by squeezing the pelvis with jerky movements, you can listen to a crunching sound in the area of ​​the pubic symphysis using a phonendoscope. B) Raising the leg bent at the knee with the patient lying on his stomach causes sharp pain in the sacroiliac joint. When trying to turn to one side, the patient carefully fixes the lumbosacral spine and pelvis; resting against the headboard of the bed, the patient turns his whole body due to severe pain in the iliosacral joint, movements are also limited in the hip joint.

S-m Otaraeva I. A., Otaraeva B. I. - Proposed for the purpose of differential diagnosis: light load on the straightened lower limb on the affected side by tapping the heel bone with a hammer. In the case of sacroiliitis, the pain intensifies in the joint area. This symptom turns out to be positive in all patients with brucellosis sacroiliitis in the subacute and chronic periods and is negative in lumbosacral radiculitis and other lesions of the peripheral nervous system.

Eriksen - a differential diagnostic sign of pathology of the sacroiliac joint and hip joint, polyarthroneuromyalgia. If a patient quickly compresses both iliac bones, the appearance of pain indicates the presence of pathology in the area of ​​the sacroiliac joint.

23. Interpretation of R-images in patients with damage to the musculoskeletal system due to infectious diseases (brucellosis).

24. Preparation of a smear and a thick drop of blood for malaria

The slides on which the preparations are prepared must be well washed and degreased. The skin of the finger is wiped with alcohol and pierced. The first drop of blood that appears is wiped off with dry cotton wool, then the finger is turned with the puncture down and the second drop is touched with a glass slide. The smear should not reach either the end or the edges of the slide. Therefore, a drop of blood should have a diameter of no more than 2–3 mm. The ground glass slide used to make the smear must be narrower than the glass on which the smear is applied. To prepare a smear, a ground glass is placed in front of a drop of blood at an angle of 45° and moved forward until it comes into contact with it. When the blood is evenly distributed between both glasses, make a smear with a quick movement.

The prepared thick drops are dried at room temperature for at least 2–3 hours without any additional heating to avoid blood fixation. After the drop has dried, Romanovsky-Giemsa paint is poured onto it (diluted in the ratio of 2 drops of paint per 1 ml of distilled water). The average painting time is 30 – 45 minutes. The colored drop is carefully rinsed with tap water (a strong stream can wash away the drop) and dried in a vertical position.

Smears are fixed by placing them in methyl alcohol for 3 minutes or in 96% ethyl alcohol for 10 minutes. The fixed preparations are dried in air. Then the preparations are placed in a special container and stained with azure-eosin dye according to Romanovsky - Giemsa for 20 - 30 minutes. After this period, the container is placed under a weak stream of water and washed. A drop on a smear is colored in the same way as a thick drop.

The washed preparations are dried and examined under a microscope. In infected red blood cells, malaria plasmodia are visible with blue cytoplasm and a bright red nucleus. The presence of malaria plasmodium in the patient’s blood is indisputable evidence of the disease.

25. PROCEDURE FOR PUT ON AND REMOVE PROTECTIVE (ANTIPLAGU) SUIT

1) Pajamas (Koisuit).

2) Socks, boots.

3) Large headscarf (hood).

4) Anti-plague robe.

5) Cotton-gauze mask.

7) Gloves

The phonendoscope is put on in front of the headscarf. The ribbons on the collar of the robe, as well as the belt, are tied in front on the left side, always with a loop; then the ribbons on the sleeves are tied. The mask is put on the face so that the mouth and nose are covered, so the upper edge of the mask should be at the level of the lower part of the eye socket, and the lower edge should be under the chin. The ribbons of the mask are tied with a loop like a sling bandage. After putting on the mask, cotton swabs are placed on the sides of the nose to prevent air from passing under the mask. The lenses of the glasses are rubbed with a piece of dry soap to prevent them from fogging. The towel is placed behind the belt.

Removal procedure

After finishing work, the suit is removed slowly, in a strictly established order, immersing gloved hands in a disinfectant solution after removing each part of the suit. Boots are wiped from top to bottom with separate swabs moistened with a disinfectant solution. Take out the towel. Remove glasses by moving up and back. Without touching open areas of skin, they are freed from the phonendoscope. Glasses and a phonendoscope are placed in a jar with 70% alcohol. Remove the mask by holding the ties and, without letting them out of your hands, fold the mask with the outer side inward. Then, lowering the upper edges of the gloves, remove the robe, while simultaneously folding it from the outside inward. The scarf is untied and removed, then the gloves and, finally, the pajamas. Once freed from the suit, hands are treated with 70% alcohol and washed thoroughly with soap.

After each use, the anti-plague suit is disinfected.

Content

A neuroinfection that affects the membranes of the spinal cord and brain, accompanied by changes in the cerebrospinal fluid, is meningitis. For every 100 thousand people, there are 10 cases of the disease in children under 14 years of age, of which 80% are children under 5 years of age. The mortality rate is influenced by age - the lower it is, the more likely death is.

What is meningitis

The infectious process affects the membranes of the brain. Meningitis can be caused by bacteria, viruses or fungi that enter the body through air or water. The reason for the high danger of meningitis is explained by the development of infectious-toxic shock, which is caused by the massive reproduction and death of pathogens.

Endotoxins produced by meningococci disrupt microcirculation, promote intravascular coagulation, and disrupt metabolism. The result is cerebral edema, death from paralysis of the respiratory center.

Typical pathogens

The source of infection is humans. For 1 sick person there are 100-20,000 bacteria carriers. Depending on the age of the patient, the following pathogens are more often detected:

• Up to a month of life - group B streptococci, Escherichia coli strain K1, Lactobacillus monocytogenes.
• 1-3 months – group B streptococci, Escherichia coli, pneumonic streptococcus, Neisseria, hemolytic infection.
• 3 months – 18 years – Neisseria (meningococcus), pneumostreptococcus, hemolytic infection.

Serous childhood meningitis is caused by ECHO, polio, herpes, and Epstein-Barr viruses. Other pathogens include rickettsia, spirochetes, and toxoplasma.

A person or a bacteria carrier becomes a potential source of infection. The following factors contribute to the development of the disease in newborns:

• adverse pregnancy, childbirth;
• oxygen starvation (hypoxia);
• tuberculosis;
• infection.

In children, the causes are purulent otitis and tonsillitis. Predisposition to the disease is due to immaturity of the immune system and permeability of the brain barrier. Contributing factors are:

• malnutrition;
• insufficient care;
• hypothermia, hyperthermia.

Classification of the disease

Meningitis is divided into primary (in the meninges) and secondary (spread of infection from other foci). The course of infection is divided into:

• fulminant (dead within 24 hours);
• acute (develops up to a week);
• subacute (from several days to several weeks);
• chronic (more than 4 weeks).

According to the nature of the cerebrospinal fluid, meningitis can be serous (there are no impurities in the liquid), purulent (with bacteria and leukocytes), hemorrhagic (with hemorrhages).

Complications after meningitis in children

Severe consequences of meningitis in children:

• dropsy;
• stunning, coma;
• epilepsy;
• ataxia, hemiparesis (muscle weakness, paralysis));
• cardiac arrest, respiratory arrest;
• ventriculitis syndrome - inflammation of the ventricles of the brain.

Signs of meningitis infection in a child

Symptoms of meningitis in children depend on the pathogen that affects them:

• The bacterial form has a rapid onset and rapid development. The child becomes excitable during sleep, cries, screams with soothing movements. Infants experience repeated vomiting and dehydration. Older children complain of headaches.
• Viral form - symptoms increase gradually. Sometimes meningitis manifests itself suddenly - nausea, inflammation of the conjunctiva, nasopharynx, and muscles. Complications include encephalitis and coma.

First manifestations of the disease

Signs of serous meningitis in a child:

• Headache - due to intoxication, increased pressure, felt throughout the entire volume.
• Dizziness, vomiting, fear of light and sound - appear on days 2-3 of illness. Vomiting does not depend on food intake. Any touch can increase pain and dizziness.

In the first days of the development of the disease, infants become very excited and anxious. They suffer from diarrhea, drowsiness, regurgitation, and convulsions. Brain symptoms appear from the first days:

• muscle rigidity - the child cannot tilt his head or does it with difficulty;
• Kernig's sign - bending of the legs when tilting the head to the chest;
• pointer dog pose - turns to the wall, bends his legs towards his stomach, throws back his head;
• diplopia (double vision);
• tachypnea;
• visual impairment;
• decreased hearing acuity;
• hallucinations;
• pink rash - gradually spreads from the feet to the face (this is the most dangerous sign of incipient sepsis).

Clinical syndromes of meningitis

The course of the disease is accompanied by general infectious, cerebral, meningeal symptoms. One of the syndromes is more pronounced, the other may be completely absent. Signs of all three are more common.

General infectious syndrome

In children, a group of symptoms is characterized by chills and tachypnea. Other signs:

• pallor or redness of the mucous membranes;
• loss of appetite;
• insufficiency of the adrenal glands, respiratory organs;
• diarrhea.

General cerebral

When meningitis develops in children, the following signs appear:

• vomit;
• disturbances of consciousness, coma;
• fever;
• convulsions;
• strabismus;
• hyperkinesis (excitement);
• hemiparesis (muscle paralysis).

Manifestations of meningeal syndrome in children

The most typical manifestations of the disease are:

• hyperesthesia (sensitivity to light, sounds);
• thrown back head;
• stiff neck;
• blepharospasm (spasm of the eye muscles);
• fontanel tension in infants.

Diagnostics

If you suspect a child has meningitis, you should urgently show him to a pediatrician, who can send the patient to an infectious disease specialist. Consultations with an otolaryngologist and neurosurgeon are important for diagnosis. Important procedures for determining the disease:

• lumbar puncture;
• cerebrospinal fluid analysis to determine etiology;
• the presence and increase in the number of antibodies in blood serum by serological methods;
• polymerase chain reaction to study the pathogen, blood cultures and nasopharyngeal secretions;
• neurosonography;
• electrocardiogram;
• X-ray of the skull.

How to treat meningitis in a child

If a disease is suspected, the baby is hospitalized. Treatment of meningitis in children includes etiotropic or pathogenetic therapy. Additionally, diet and bed rest are indicated.

Etiotropic therapy

This area of ​​treatment includes:

• parenteral administration of antibiotics for 10-14 days (penicillins, aminoglycosides);
• use of gamma globulin;
• therapy Acyclovir, immune support agents, interferons.

Pathogenetic treatment

In severe cases, ultraviolet irradiation of blood is indicated in the hospital. The pathogenetic approach includes treatment areas:

• detoxification – glucose-salt solutions parenterally;
• dehydration - purpose Mannitol, Furosemide;
• against seizures - the use of sodium thiopental;
• prevention of ischemia – nootropics.

Prognosis and prevention

The prognosis for most is favorable, but 1-5% of cases are fatal. After an illness, a child may suffer from asthenia and hypertension, so he needs to be observed by a pediatrician. With a different outcome, hydrocephalus and arachnoiditis may develop.

Prevention of meningitis in children includes 3 methods of protection:

1. Non-specific – limiting contacts. During an epidemic, it is important to use respirators. To prevent illness, it is important to treat diseases completely and on time, and teach children the rules of personal hygiene.
2. Specific – vaccination against rubella, measles, mumps, chickenpox, pneumococcus, meningococcus, hemophilus influenzae.
3. Chemoprophylaxis – for children who have had close contact with patients. Includes an antibacterial course.

Video

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Every doctor should know meningeal symptoms. This group of symptoms is of utmost importance in neurology. Meningal symptoms occur when the membranes of the brain are irritated. Irritation usually appears as a result of meningitis, but it can be triggered, for example, by hemorrhage inside the brain or the disintegration of a tumor. Meningeal signs are of great importance for diagnosing the disease. At the slightest inflammation of the meningeal membranes, the patient should be examined, especially for children. Today medicine has identified more than 30 symptoms. Meningeal signs are usually named after the author who discovered them. The most significant symptoms will be discussed below.

Kernig's symptoms are typical not only for children and patients who develop meningitis, but also for people with problems in the knee joints. Meningeal Kernig syndrome allows an accurate diagnosis to be made in children and adults. The essence of this syndrome is that when bending and straightening the knee and hip joint (with the help of a doctor), the leg does not fully straighten. This meningeal syndrome is being studied in 2 stages.

First, the doctor bends the patient's leg while he is lying on his stomach, and then releases the pressure and releases the leg, which begins to passively extend.

In healthy children and adults, this syndrome does not manifest itself, and the leg calmly returns to its original position. Kernig syndrome allows not only to diagnose the presence of meningitis, but also to determine the extent to which the brain is affected by the infection. In addition, it is possible to determine the prognosis of pathological changes in nervous tissue, and in what dynamics the disease develops.

Other options

Meningeal Strumpel syndrome manifests itself as slowly progressive lower spastic paraplegia. Hand function is preserved. The cranial innervation remains preserved. In later stages, urinary incontinence may occur. Sometimes there is a decrease in pain. The symptom is checked by pressing on the knee joint. Inflammation of the meninges is diagnosed if the toes fan out when pressed, as well as spontaneous extension of the big toe. When the form of the pathology is complex, the symptoms may be accompanied by hearing loss, cerebellar ataxia, ichthyosis, etc.

Meningeal Guillain syndrome in children and adults is manifested by the following symptoms:

1. Catarrhal inflammation of the respiratory tract.
2. General weakness, fatigue, malaise.
3. Increase in body temperature to extreme values.
4. Failure in the functioning of the gastrointestinal tract.

Meningeal Guillain syndrome in children and adults at the initial stage is manifested by general weakness in the muscles of the limbs, which indicates the destruction of nerve cells. In the later stages of pathology development, loss of sensation in the limbs occurs. Another meningeal symptom is called Mendelian symptom. The characteristic features of the development of the pathological condition are that children or an adult patient develop dull pain in the appendix area. Nausea and vomiting may develop. A white coating may appear on the tongue. The next meningeal sign is Flatau's symptom. The symptom manifests itself in the dilation of the patient’s pupils when he passively or intensively bends his head.

Checking for meningeal symptoms is very important. Brudzinski's symptoms test not only the target organ, but also all systems, because usually the lesion affects the membranes of the brain and the entire body as a whole. Brudzinski's signs are checked as follows:

1. Top sign. The patient should lie on his back and try to touch his chin to his chest. If inflammation of the membranes is present, then the leg will involuntarily bend at the knee and hip joint.
2. Average sign. The patient is gently pressed on the pubis. Inflammation is present if he pulls his legs towards his stomach.
3. The lower sign is checked as Kernig's sign.
4. Buccal sign. The patient is pressed on the area under the cheekbone, and if inflammation of the membranes of the brain is present, then the sick person’s arm will bend or the hand will rise.

These signs were introduced into practice by the Polish doctor Joseph Brudzinski. Since the beginning of the 20th century, they have been standard in diagnosing meningitis in children and adults.

Another meningeal syndrome that allows the diagnosis of meningitis is a stiff neck. It can be checked by bending the patient's head from a supine position. The doctor tries to pull the patient's head towards the chest, but if there is rigidity (high muscle tone), then this will not work. When checking, a lifting of the body may be noticed. Neck stiffness is of great importance in the diagnosis of cerebral hemorrhage and meningitis.

The next symptom is the lying dog pose. With severe damage to the nervous system, the functioning of the entire body is disrupted.

With meningeal syndrome, an increase in muscle tone occurs, and the patient acquires a lying dog pose, or otherwise a cocked position. This position indicates that meningitis is extremely severe. The symptom is unfavorable.

Opisthotonus, trismus of masticatory muscles

Opisthotonus is a posture characterized by a tilted head back, arching of the spinal column and extension of the lower extremities. A person takes this position when there is inflammation of the membranes of the brain, meningitis, tumors, tetanus or hemorrhagic stroke. Rarely does a person take such a position when he is having a hysterical attack. In children, opisthotonus occurs with purulent meningitis or tetanus and indicates brain damage. Another symptom of inflammation of the meninges is trismus of the masticatory muscles. It manifests itself as a spasm of these muscles and an inability to move the jaw freely. The potty symptom usually occurs in children who have bacterial meningitis. When the baby sits on the potty, he quickly tries to lean on the floor behind his back.

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He does this in order to avoid tension in the muscles in the back of his head. Levinson's symptom is very important in the diagnosis of viral, bacterial and tuberculous meningitis. The symptom is checked very simply. The patient, when trying to pull his head towards the chest, involuntarily opens his mouth. This sign is not specific and is used in complex cases. With serous, tuberculous, viral meningitis, Bickel's symptom appears. Its development occurs when there is serious inflammation of the meninges. Sometimes Bickel's sign occurs with cerebral hemorrhage. The symptom is expressed by constantly bending the elbows. Also, the patient constantly wants to hold the blanket being pulled off him. This condition remains the same even if the patient is in a feverish state.

Thanks to all of the above symptoms, it is possible to promptly diagnose life-threatening pathologies and prescribe treatment. After all, treatment started on time gives an 80% successful outcome.

Content

Meningitis is a demyelinating disease of the nervous system, leading to the destruction of the myelin sheath of neurons. Treatment at home is prohibited. It is important to identify symptoms promptly and get immediate medical help. The difficulty of diagnosis lies in the identity of the symptoms of the disease with the flu. A common form of the disease is bacterial meningitis. It does not destroy the body, but weakens it. If you notice the following symptoms, consult a doctor immediately.

What are the meningeal signs and symptoms?

The disease occurs in two forms: viral and bacterial. Depending on the type, patients exhibit characteristic symptoms. The main meningeal symptoms in adults:

• severe weakness in children and adults;
• temperature rise to 39 degrees;
• aches, especially in the lumbar region;
• irregular breathing rhythm, increased heart rate;
• Blood clots may appear.

Meningeal symptoms in children are as follows:

• severe headache radiating to the neck and back;
• vomiting due to unbearable headaches;
• increased sensitivity to touch;
• convulsions, hyperesthesia;
• Pointer dog pose is a meningeal symptom of the development of a severe form of the disease.

Doctors combine all these symptoms into one syndrome. The combination of signs of the disease is individual for each patient. The main and most common irritations of the meninges are considered to be stiff neck, Kernig's sign. The incubation period of the disease is 2-10 days. The disease is accompanied by accompanying signals that often mislead doctors. Diagnosis is carried out during hospitalization of the patient. Treatment includes tonic measures aimed at strengthening the body.

Test in the Romberg pose

A simple diagnostic test - the Romberg test - reveals dysfunction of organ systems that are involved in maintaining balance. These include: the vestibular apparatus, the proprioception system (deep sensitivity), and the cerebral functions of the cerebral cortex. Conduct: the patient stands straight, legs together, with eyes closed, stretches his arms forward. Swaying, deviation to the right or left, etc. indicate damage to the cerebellum, neurological abnormalities.

Kernig's sign

One of the important signs of a disorder of the meninges is the Kernig sign. Named in honor of the Russian therapist V.M. Kernig. Method of implementation: the patient, lying on his back, bends his leg at the joints 90 degrees. Next, the doctor attempts to straighten the leg. With meningitis this cannot be done. The analysis is positive to an equal extent on both sides of the test. Occurs in the early stages of meningitis.

Babinski reflex and asynergia

Babinsky's asynergy is performed as follows: the patient lying on his back is crossed with his arms and asked to sit down. On the affected side, the patient's lower limbs rise. Another interpretation: when pushing back or falling, the patient with damage to the cerebellum falls backward. There is no bending of the knee joints to maintain balance. Asynergia – indicates difficulties in performing combined movements. Occurs at the initial stage of development of meningitis and other diseases.

Brudzinski's sign

The combination of signs resulting from brain damage is Brudzinski’s symptom. Occurs in several diseases at once. The following types are distinguished:

• Upper. It manifests itself as involuntary bending of the legs, pulling towards the stomach while hanging (lowering) the head down.
• Average. When pressure is applied to the pubis, the legs bend.
• Lower. When checking, a Kerning symptom is revealed on one side, on the other - the leg, bending, is pulled towards the stomach.
• Buccal. When you press on the zygomatic arch, your shoulders rise and your arms bend.

Muscle stiffness

It appears in almost 80% of cases. Indicates irritation of the membranes of the brain, disorders of the central nervous system. Rigidity of the neck muscles is determined with the patient in a supine position. When passively bending the head, tension occurs in the muscles of the neck and occipital muscles. They prevent the chin from moving towards the chest. Muscular rigidity of the cervical spine is often accompanied by tightness of the muscles of the back and limbs. False rigidity also occurs in the presence of spondyloarthrosis, spondylosis of the cervical spine.

Rossolimo's symptom

The finger reflex is caused by striking the fingers on the phalanges of the 2-5 toes of the patient's foot. The patient's reaction is to flex the soles or, in rare cases, abduct them. The patient is examined in a lying position. All fingers or 2 and 5, one thumb can participate in the movement. Healthy individuals have no symptoms. The symptom is a pathological flexion type, manifested when the pyramidal tract is damaged. Second option: the symptom is determined on the patient’s hands.

Oppenheim's sign

During the analysis, extension of the big toe is observed during irritation of the medial surface of the leg. Method of implementation: the doctor uses the phalanx of the thumb or index finger to forcefully carry out sliding movements from top to bottom along the medial surface of the leg. The norm is to bend the fingers. With meningitis, extension of the toes occurs with a slight turn of the foot. Oppenheim's sign is similar to Babinski's reflex. The reflex occurs in most lesions of cerebral activity.

Video about meningeal symptoms

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.