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A violently ill patient with neck stiffness during the Texas meningitis epidemic of 1911 and 1912. Neck stiffness, stiff neck and nuchal rigidity are terms often used interchangeably to describe the medical condition when one experiences discomfort or pain when trying to turn, move, or flex the neck.
Meningism is a set of symptoms similar to those of meningitis but not caused by meningitis. [1] [3] [4] 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, [1] [2] especially in children and adolescents. [2]
The corresponding adjective is nuchal, as in the term nuchal rigidity for neck stiffness. In many mammals, the nape bears a loose, non-sensitive area of skin, known as the scruff, by which a mother carries her young by her teeth, temporarily immobilizing it during transport.
Some of the possible symptoms of chronic meningitis (due to any cause) include headache, nausea and vomiting, fever, and visual impairment. Nuchal rigidity (or neck stiffness with discomfort in trying to move the neck), a classic symptom in acute meningitis, was seen in only 45% of cases of chronic meningitis with the sign being even more rare in non-infectious causes.
The patient with meningococcal meningitis typically presents with high fever, nuchal rigidity (stiff neck), Kernig's sign, severe headache, vomiting, purpura, photophobia, and sometimes chills, altered mental status, or seizures. Diarrhea or respiratory symptoms are less common.
Symptoms may include headache and nuchal rigidity (being unable to bend the head forward). It may be acute or chronic. [1] Accumulation of granulomas in particular areas of the brain can lead to abnormalities in the function of that area.
From the anterior border of the nuchal ligament, a fibrous lamina is given off. This is attached to the posterior tubercle of the atlas, and to the spinous processes of the cervical vertebrae, and forms a septum between the muscles on either side of the neck. The trapezius and splenius capitis muscle attach to the nuchal ligament.
Spinal flexion leads to nuchal rigidity, or stiff neck, due to the stretching of the inflamed meninges. [16] The increase in intracranial pressure stimulates the area postrema to create nausea sensations which may lead to brain herniation and damage to the reticular formation. [16]