The negative symptom of Kernig is typical for. What is the symptom of Kernig and Brudzinski

Brudzinsky's symptoms

Brudzinsky's symptoms- a group of symptoms that occur due to irritation of the meninges. They are one of the meningeal symptoms and can occur with a number of diseases.

Described by the Polish pediatrician Josef Brudzinsky at the beginning of the 20th century.

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Notes

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See what "Brudzinsky's symptoms" are in other dictionaries:

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When the membranes of the brain and spinal cord are damaged as a result of a meningeal infection or hemorrhage, the most important symptoms for establishing a primary diagnosis are manifestations established thanks to the works of Polish and Russian pediatricians - Josef Brudzinsky and Vladimir Kernig.

The methods developed by therapists for the primary diagnosis of lesions of the meninges make it possible to provide the necessary therapeutic treatment in a short time, preventing the terrible consequences of the disease. Let's take a closer look at the signs of brain injury in this article.

The method of determining Brudzinsky and Kernig is to identify early signs of irritation of the meninges by infectious pathogens or traumatic injuries.

The syndrome of Kernig and Brudzinsky is of particular value, as it allows to determine the presence of the disease at an early stage, ahead of instrumental and laboratory diagnostics.

The causes of the positive syndrome are diseases such as:

Scientists have been studying the effect of CNS damage on the primary reflexes of patients for many years. As a result of research, they found a relationship between the resistance of the muscles of the neck, lower and upper extremities and brain damage.

Kernig syndrome

The Kernig symptom developed in the 20th century has not lost its relevance to this day and is help in the diagnosis of serious pathologies of the central nervous system.

To test for a positive Kernig's symptom, the patient is placed on his back and one leg is bent at a right angle in the pelvic and knee joint.

Further, the doctor tries to passively extend this leg at the knee joint, but this is impossible due to increased extensor rigidity.

This symptom appears on both sides of the patient's body.

An exception to the rule are those cases when the patient, in addition to the lesion of the meninges, has muscle weakness, then the Kernig symptom may not be negative on both or one side of the body.

In old age, the flexor muscles are prone to increased tone and contracture. In this case, a false-positive syndrome may be noted.

Brudzinsky syndrome

Brudzinsky studied the reflexes of other articular joints in case of damage to the meninges. To confirm the syndrome, it is required to check involuntary flexion of the knee joints with the patient lying on his back.

There are upper, middle, lower Brudzinsky syndrome.

Upper a symptom characterizes an increase in the tone of the muscles of the neck. When the doctor tries to passively bring the patient's chin to chest, there is a tightening of the knee joints with simultaneous resistance in the neck.

Middle or a pubic positive symptom is found if, when pressing on the pubic bone, there is an involuntary flexion movement in the legs.

Lower the symptom was developed jointly with Kernig and exactly repeats the previously described phenomenon: with passive flexion of the patient's leg, it is not possible to straighten it at the knee.

In addition, Brudzinsky noticed that when pressing on the lower point of the zygomatic arch, a person involuntarily contracts the trapezius muscle, pulling his shoulders to his ears, and also bends upper limbs at the elbows.

What to do with a positive reaction

A positive Brudzinski and Kernig syndrome suggests the presence of pathologies of the meninges. However, the initial diagnosis must be confirmed by a general clinical picture, ultrasound, MRI, CT, blood tests, lumbar and physical examination.

Based on the results of the diagnosis, the type and degree of the disease, the doctor selects an effective treatment.

meningeal infection requires taking antibiotics, reducing the reabsorption of water and salts in the tissues and their accelerated excretion from the body, as well as restoring the balance of electrolytes.

The patient is scheduled for surgery and radiation therapy.

With cerebral hemorrhage the patient is prescribed medications that prevent the formation of blood clots and increased blood clotting, prevent damage to neural networks, and inhibit oxidation free radicals and other toxic substances.

In severe stages, the disease undergoes surgical intervention.

Conclusion

Symptoms of Kernig and Brudzinsky allow early detection of the pathology of the spinal cord and brain. Thanks to timely treatment, therapy in most cases ends in a complete recovery of the patient. When malignant tumors and thrombosis are detected, early treatment does not diminish the consequences of the disease, but it can prevent some symptomatic manifestations.

To prevent damage to the lining of the brain, experts recommend vaccinating against infectious pathogens, treating SARS, influenza, bacterial diseases on time, regularly, monitor blood pressure and follow a healthy lifestyle.

Kernig's symptom is one of the primary signs confirming the presence of irritation of the lining of the brain. The condition is observed with meningitis, stroke and other pathologies of the brain tissue. The symptom bears the name of the Russian doctor Kernig Vladimir Mikhailovich. He studied reflexes in brain damage, discovered and described this phenomenon.

Kernig's sign

Diagnostics

The syndrome is diagnosed as follows:

• the patient lies on his back, the doctor bends his leg at the hip joint and at the knee, the angle of flexion is ninety degrees;
• at the next stage, the doctor tries to straighten the leg at the knee joint.

If the patient has meningeal syndrome, then the lower limb will not fully straighten. This is due to the increased tone of the muscles responsible for flexing the legs.

Causes of Kernig's symptom

In medicine, there are the following violations that are the causes of this condition:
• meningitis - Kernig's syndrome diagnoses this disease in the early stages of the disease;
• herniated discs, with cancer of the spinal cord;
• subarachnoid hemorrhage - it can be determined in the near future after the onset. In this case, Kernig's syndrome will show a positive result;
• a tumor on the spinal cord - the main symptom of this disease is pain localized in the direction of the spinal nerve, meningeal syndrome will be a secondary symptom.

Manifestations of Kernig's symptom

1. A positive result - in this case, the legs are not able to fully straighten at the knees. This is due to spasm in the muscles of the leg. The result suggests that the membranes of the brain are irritated, and intracranial pressure is increased.
2. A negative result - manifests itself when the patient has hemiparesis (increase or decrease in muscle tone, which is unilateral), with neurological diseases(Alzheimer's or Parkinson's).

What diseases lead to positive Kernig's syndrome

Liver disease

With pathologies of this organ, a positive reaction of the Kernig symptom is recorded. The fact is that with liver diseases, the amount of bilirubin increases, jaundice appears. These factors lead to meningeal changes, since toxic substances act on the brain tissue. In liver disease, the following symptoms are observed:

• forced posture of the patient - arched torso and retracted abdomen;
• neck muscles become rigid,
• severe headaches that are caused by increased intracranial pressure;
• the back muscles of the thigh are very tense.

Bacterial infections

A number of diseases that are caused by bacteria lead to meningitis. These include salmonellosis or diphtheria. With these diseases, the patient has a positive symptom of Kernig, but it is accompanied by other symptoms:

• the patient has stiff neck muscles;
• the patient is forced to take the position of the "pointing dog" - he draws in his stomach, arches his back, presses his hands to his chest.

Cerebral disorders

Any damage to the brain tissue (with inflammation, cancer, trauma) manifests clinical symptoms. They are usually accompanied by Kernig's sign. Cerebral disorders are characterized by the following features:

• strong headache,
• convulsions,
• dizziness,
• disruption of the functioning of consciousness,
• nausea,
• vomiting urge.

These symptoms appear as metabolic, toxic, and vascular changes occur in the brain tissues. They also lead to disorientation in space, hallucinations, and stupor. The extreme degree of cerebral disorders is expressed in coma. In this case, all meningeal syndromes are very pronounced.

Brudzinsky syndrome

It is a group of symptoms that are meningeal. Brudzinsky's syndrome helps to identify whether there is a lesion of the meninges of the brain. This is achieved by provoking the meningeal posture.

There are five symptoms:

• pubic Brudzinsky syndrome - the doctor presses on the pubic area, in the presence of inflammation of the membrane of the brain, the patient will bend his knees;
• lower symptom - the doctor bends the patient's leg at the knee, at this time the second leg bends involuntarily.

These symptoms were brought out by the Polish doctor Josef Brudzinski. Together with Kernig's symptom, they are used in neurological practice in order to find out whether the membranes of the brain are inflamed in the patient.

This syndrome allows you to determine whether meningitis is present in baby. It consists in the fact that the baby is taken under the armpits and lifted. In this state, he pulls his legs up to his stomach and holds them in this state, throws his head back a little. A healthy child in this position will freely bend and unbend his legs.

Meningitis

Causes of meningitis

This disease is infectious. It causes inflammation of the membranes of the brain and spinal cord. Meningitis ranks tenth among all occurring infections.

Meningitis can occur for the following reasons:

• • taking certain types medicines: corticosteroids, immunosuppressants, certain types of antibiotics;
  • furunculosis of the face or neck,
  • the presence of tumors or cysts of the brain,

Inflammation of the meninges is characterized not only by the symptom of Kernig, Brudzinsky and Lesage. There are a number of other signs of the disease. The disease begins suddenly, at first similar to the flu. It manifests itself with the following symptoms:

• severe weakness,
• rise in temperature to 39 degrees,
• painful sensations throughout the body,
• deterioration in appetite.

Within a few hours or days, the following symptoms will begin to appear:

• vomit,
• convulsions,
• severe, unbearable pain, which is aggravated by turning the head or any noise,
• rashes on the skin,
• strabismus,
• confusion of consciousness (in severe forms of meningitis).

In this article, we tell how intercostal neuralgia manifests itself on the left.
What symptoms indicate the presence of intercostal neuralgia on the right, read here

At-risk groups

Meningeal syndromes occur in the following groups:

• • In people who have been treated for a long time with chemotherapy drugs, cytostatics, some types of antibiotics;
  • In patients who have had or are suffering from bacterial infections. For example: toxoplasmosis or echinococcosis, etc.;
  • Small children, young and old people are predisposed to the disease;
  • A risk factor is skipping vaccination - if a child under 2 years of age has not been vaccinated against parotitis, then the likelihood of meningeal syndromes increases;

• People suffering from liver diseases, infections caused by bacteria;
• Patients who have fixed cerebral disorders (they can be observed with brain injuries, brain tissue cancer and other inflammations);
• Visiting places (countries in Africa) where there is a high percentage of meningitis - when traveling to such countries, it is worth getting the necessary vaccinations.

Hemorrhages under the membranes and some other conditions. It is named after the Russian therapist Vladimir Mikhailovich Kernig (1840-1917) who described it.

Detection technique

This symptom is checked as follows: the leg of the patient lying on his back is passively flexed at an angle of 90 ° in the hip and knee joints (the first phase of the study), after which the examiner makes an attempt to straighten this leg in the knee joint (second phase). If a patient has meningeal syndrome, it is impossible to straighten his leg in the knee joint due to a reflex increase in the tone of the leg flexor muscles; in meningitis this symptom is equally positive on both sides. At the same time, it must be borne in mind that if a patient has hemiparesis on the side of paresis due to a change in muscle tone, Kernig's symptom may be negative. However, in older people, especially if they have muscle rigidity, there may be a false impression of a positive Kernig's sign.

Notes

Wikimedia Foundation. 2010 .

See what "Kernig's Symptom" is in other dictionaries:

Kernig's sign- The leg of the patient lying on his back is bent at the hip and knee joints, after which an attempt is made to straighten it at the knee joint. Full extension of the leg in the knee joint at the same time is impossible due to tonic muscle tension, ... ...

KERNIG'S SYMPTOM- (Kemigs sign) a symptom of meningitis, in which the tendons of the muscles of the legs become so stiff that the patient cannot extend the legs at the knees if they are held by the thighs at right angles to the body ... Explanatory Dictionary of Medicine

A symptom of meningitis in which the tendons of the muscles of the legs become so stiff that the patient cannot extend the legs at the knees if they are held by the thighs at right angles to the body. Source: Medical Dictionary... medical terms

Kernig symptom- when trying to straighten the patient's leg in the knee joint, bent at a right angle in the hip and knee joints, this cannot be done due to pain and its sharp resistance. When trying to bend the leg at the hip joint and when ... ... Encyclopedic Dictionary of Psychology and Pedagogy

Symptom of Brudzinsky lower- An attempt to straighten the leg at the knee, previously bent at the hip and knee joints (see Kernig's symptom), causes the other leg to be pulled to the stomach. Belongs to the group of meningeal symptoms. Described by Brudzinski... Encyclopedic Dictionary of Psychology and Pedagogy

KERNIG'S SYMPTOM- KERNIG'S SYMPTOM, established by the author in 1883, is the impossibility of complete extension lower extremities in the knee joints, when the limbs are bent at the hip joints (see figure). Observed with spinal cerebro ... ... Big Medical Encyclopedia

KERNIG'S SYMPTOMS- - are named after the Russian therapist V. M. Kernig (1840–1917) who described them. 1. A sign of irritation of the meninges ( meningeal symptom): the inability to fully straighten the leg at the knee joint, previously bent at the hip ... Encyclopedic Dictionary of Psychology and Pedagogy

I Kernig symptom (V.M. Kernig, domestic therapist, 1840 1917) meningeal symptom, impossibility of passive extension of the leg, previously bent at a right angle in the hip and knee joints, see Meningitis. II Kernig's symptom (In ... Medical Encyclopedia

KERNIGA - LASEGA SYMPTOM- (described by V. M. Kernig and the French physician E. Ch. Lasegue, 1816-1883) - a sign of lumbosacral sciatica - tonic tension in the muscles of the lower leg when trying to straighten the leg in the same position as with Kernig's symptom ... Encyclopedic Dictionary of Psychology and Pedagogy

- (V. M. Kernig, 1840 1917, father internist) meningeal symptom: the impossibility of passive extension of the leg, previously bent at a right angle in the hip and knee joints ... Big Medical Dictionary

Various diseases of the meninges are very dangerous, so it is important to identify them in time and start treatment. It happens that patients do not immediately go to the doctor because of frequent headaches. But this sign can indicate inflammation, an infection in the brain, or a stroke. For early and accurate diagnosis, most doctors use the Kernig and Brudzinski sign test. This allows you to correctly diagnose and start treatment on time.

What symptoms should be tested for?

Brain damage is expressed in different ways. The main one is a severe headache. If it continues for a long time or is accompanied by other symptoms, it is necessary to check the patient for Kernig's or Brudzinsky's symptom. This is necessary in order to determine in time that inflammation has begun. In what cases is such a diagnosis carried out:

• with severe headaches;
• convulsions;
• loss of appetite, nausea and vomiting;
• dizziness;
• disturbances of consciousness;
• an increase in body temperature above 39º;
• patient confusion, confusion, great weakness;
• hallucinations;
• neck muscle stiffness;
• often the patient takes a forced posture - arching his back and pulling in his stomach.

The doctor will definitely check the patient for the symptoms of Kernig and Brudzinsky if he has a head or spinal cord injury, severe purulent otitis media or sinusitis, sepsis and some other conditions.

What is Kernig's symptom

This is one of the important signs that allows you to diagnose inflammatory diseases brain. It is named after the Russian infectious disease doctor Kernig. He was the first to determine how quickly a lesion of the meninges can be detected. The technique for carrying out this symptom is simple, so you can perform it even at home. What is needed for this:

• put the patient on his back;
• bend him one leg in the hip and knee joint up to 90º;
• then try to straighten it.

A positive symptom of Kernig is considered if the leg cannot be straightened. This is due to the fact that due to damage to the meninges during an inflammatory process or hemorrhage, the nerve impulses going to the muscles are disturbed. And the tone of the flexor muscles is increased. A positive result also indicates increased intracranial pressure and irritation of the meninges. After all, all nerve fibers have a close connection with the brain. Therefore, the condition of the meninges is often checked by the work of the lower extremities.

If it is impossible to straighten the patient's leg bent at the knee, this indicates a lesion of the meninges

What can a positive Kernig's sign indicate?

Most often, such a reaction accompanies meningeal lesions of the brain. But Kernig's symptom can be positive in other cases:

• with severe liver damage with an increase in the amount of bilirubin;
• some bacterial infections, such as salmonellosis or diphtheria, can also cause brain damage;
• with head injuries leading to hemorrhage or inflammation;
• but sometimes a positive reaction can be in older people with skeletal muscle damage, so in this case, an additional test for the Brudzinsky symptom is used.

Characteristics of Brudzinsky's symptom

If any neurological disorders are suspected, the reaction to the Brudzinsky symptom is checked. It is named after a Polish doctor who investigated neurological disorders and was the first to discover a method for such a test, which allows timely detection of the presence of an inflammatory process in the membranes of the brain. There are several varieties of Brudzinsky verification.

• The upper symptom is detected in any brain lesions. It is checked as follows: the patient lies on his back, he is asked to tilt his head forward and press his chin to his chest. A doctor can do this too. Such a test is considered positive if the patient involuntarily bends the legs, and the chin cannot touch the chest due to a spasm of the occipital muscles.
• In purulent meningitis, it is positive Brudzinski's mean symptom. To check it, you need to press the patient, lying on his back, on the pubis. With a positive symptom, the patient's legs involuntarily bend.
• It is also often used to check lower Brudzinski's symptom. To do this, bend the patient's leg in the hip and knee joint. The second leg involuntarily bends with it.

There are several types of diagnostics using the Brudzinsky method.

These are the most common verification methods. But sometimes a buccal symptom is used for additional diagnostics, when, when the patient presses on the cheek below the zygomatic arch, the patient involuntarily bends his arms, as well as the zygomatic symptom - when tapping on the cheekbone, bending of the knees is observed. All these methods can provide the doctor with a complete picture of the state of the meninges.

What diseases can be detected in this way

Various pathologies and inflammatory diseases of the brain are a fairly common phenomenon. They may be bacterial or viral in nature, or caused by other causes. But in all cases, positive reactions to the symptom of Kernig and Brudzinsky will be observed. They may appear weaker or stronger, depending on the nature of the lesion of the meninges. It is important that such a check be carried out comprehensively. Only when several signs are present can a diagnosis be made.

But in any case, with severe headaches, it is advisable to check the patient by the Brudzinsky or Kernig method in order to prevent the development of complications. What diseases can be detected in this way:

• meningitis on early stages;
• subarachnoid hemorrhage in the brain;
• herniated discs;
• spinal cord cancer;
• stroke.

When using such a test, it is possible to recognize the disease on initial stage

What to do with a positive reaction to these symptoms

To clarify the diagnosis, the patient should have blood tests, CT, MRI or x-rays. This will help assign proper treatment. It is desirable that it be started as soon as possible, then in many cases the prognosis for recovery will be positive. Features of treatment depend on the identified disease:

• with meningitis - these are antibiotics, detoxification, restoration of water-salt balance;
• for tumors - surgery or chemotherapy;
• in stroke - neuroprotectors, anticoagulants and other drugs.

Symptoms of Kernig and Brudzinsky allow the doctor to make a diagnosis already at the first examination of the patient. This is very important for the timely detection of inflammation or hemorrhage in the brain.