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Kernig sign is a physical maneuver used to evaluate an individual for a suspected case of meningitis, a condition characterized by inflammation of the membranes that surround the brain and spinal cord, called the meninges. Meningitis is typically caused by a viral infection, but it can also result from bacterial, parasitic, or fungal infections. Common symptoms of meningitis include a stiff neck and back; pain in the back, muscles, or neck; light sensitivity; and constitutional symptoms, such as a fever, nausea, vomiting, and headache. More severe symptoms include confusion and seizures.
A positive Kernig sign increases the likelihood for an existing meningitis diagnosis, yet a negative sign does not exclude the possibility of meningitis. Therefore, further diagnostic testing, like a lumbar puncture, should be conducted when meningitis is suspected in order to ensure a prompt and accurate diagnosis.
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Definition | The Kernig sign is a physical examination maneuver used to assess individuals with suspected meningitis. A positive Kernig sign supports the likelihood of meningitis, whereas a negative sign does not rule it out. |
Method | - Individual lying on their back with hips and knees flexed and bent at 90-degrees - The clinician slowly extends one knee at a time - Resistance / pain / inability to extend the knee is indicative of a positive Kernig sign |
Mechanism | - Movement of the spinal cord or nerves over the inflamed and hypersensitive meninges |
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Mehndiratta M, Nayak R, Garg H, Kumar M, Pandey S. Appraisal of Kernig's and Brudzinski's sign in meningitis. Ann Indian Acad Neurol. 2012;15(4):287-288. doi:10.4103/0972-2327.104337
Mount HR, Boyle SD. Aseptic and bacterial meningitis: Evaluation, treatment, and prevention. Am Fam Physician. 2017;96(5):314-322.
