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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]
Asymptomatic, mild headache, slight nuchal rigidity; Moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy; Drowsiness, confusion, mild focal neurologic deficit; Stupor, moderate-severe hemiparesis; Coma, decerebrate posturing; It gives an index of the mortality associated with the various grades.
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.
Kernig's sign is a test used in physical examination to look for evidence of irritation of the meninges.The test involves flexing the thighs at the hip, and the knees, at 90 degree angles, and assessing whether subsequent extension of the knee is painful (leading to resistance), in which case it is deemed positive. [1]
A latex agglutination test may be positive in meningitis caused by Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli and group B streptococci; its routine use is not encouraged as it rarely leads to changes in treatment, but it may be used if other tests are not diagnostic.
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.