Kernig Sign & Brudzinski Sign - Signs in Meningitis
Meningitis is one of the common intracranial complications of chronic otitis media, and may also complicate acute otitis media.
Recognizing it changes the case into a complicated otitis media, and alters the line of treatment.
In this post, we will discuss the two signs of meningeal irritation:
Kernig Sign
Brudzinski Sign
Which is the most common intracranial complication of Chronic otitis media?
Classify the complications of CSOM.
Kernig Sign
📌 Type of Sign
👉 Clinical Sign
A sign of Meningeal irritation.
🩺 How is it Elicited?
1- The patient lies supine
2- The hip is flexed to 90 degrees
3- The examiner attempts to extend the knee
⭐ In a normal patient, the knee can be extended fully.
A positive sign is:
✅ Pain in the lower back
✅ Resistance to the movement
✅ Complete inability to extend the knee
🧠 Why Does it Occur?
With the hip flexed, extension of the knee stretches the sciatic nerve and the inflamed meninges.
This causes pain and spasm, preventing full knee extension.
👨⚕️ Eponym
Named after Vladimir Kernig, who described this sign in patients with meningitis.
💡 Mnemonic
KE from KErnig
👉 Knee Extension is painful
What are the CSF findings in bacterial meningitis?
Brudzinski Sign
📌 Type of Sign
👉 Clinical Sign
A sign of Meningeal irritation.
🩺 How is it Elicited?
1- The patient lies supine
2- The examiner gently flexes the neck forward
A positive sign is:
✅ Involuntary flexion of the hip and knee
🧠 Why Does it Occur?
Neck flexion stretches the inflamed meninges.
To reduce the stretch and the pain, the patient reflexly flexes the hip and knee.
👨⚕️ Eponym
Named after Jozef Brudzinski, a Polish paediatrician, who described this sign in patients with meningitis.
💡 Mnemonic
B from Brudzinski
👉 On flexing the neck, Both hip and knee are flexed
⭐ High Yield Rapid Revision Table
Sign
Elicited By
Positive Finding
Mnemonic
Kernig Sign
Extending the knee with the hip flexed to 90 degrees
Pain, resistance or inability to extend the knee
KE: K*nee Extension is painful
Brudzinski Sign
Flexing the neck forward
Involuntary hip and knee flexion
B: Both hip and knee flexed
🧠 Viva Pearls
Kernig sign and Brudzinski sign are signs of meningeal irritation.
Meningitis is the most common intracranial complication of chronic otitis media.
Kernig sign is elicited by extending the knee with the hip flexed to 90 degrees.
Kernig sign occurs because knee extension stretches the sciatic nerve and the inflamed meninges.
Kernig sign is named after Vladimir Kernig.
Brudzinski sign is involuntary flexion of the hip and knee on flexing the neck.
Brudzinski sign is named after Jozef Brudzinski, a Polish paediatrician.
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