Brudzinski’s Sign

Original Editor ­ Oyemi Sillo

Top Contributors - Sweta Christian, Oyemi Sillo, Kim Jackson and Evan Thomas ­

Description

Brudzinski's sign is one of the physically demonstrable symptoms of meningitis. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed.[1][2]

Purpose

Indicates meningeal irritation.[3]

Technique

In a quiet environment with the client resting in a supine position:

  • Gently grasp the patient's head from behind and place the other hand on the patient's chest
  • Gently flex the neck, bringing chin to chest
  • Positive sign is involuntary flexing of hips and knees (an involuntary reaction to lessen the stretch on the inflamed meninges)

Evidence[4]

Sensitivity: 5; Specificity: 95; Positive likelihood ratio: 0.97; Negative likelihood ratio: 1.0

See test diagnostics page for an explanation of statistics.


References

  1. http://www.nlm.nih.gov/medlineplus/ency/imagepages/19069.htm
  2. Manmohan Mehndiratta, Rajeev Nayak, Hitesh Garg, Munish Kumar, and Sanjay Pandey (2012). Appraisal of Kernig's and Brudzinski's sign in meningitis.Ann Indian Acad Neurol. 2012 Oct-Dec; 15(4): 287–288. doi: 10.4103/0972-2327.104337
  3. Introduction to Emergency Medicine edited by Elizabeth Mitchell, Ron Medzon. Lippincott Williams & Wilkins, 2005
  4. Karen E. Thomas, Rodrigo Hasbun, James Jekel, Vincent J. Quagliarello. The Diagnostic Accuracy of Kernig's Sign, Brudzinski's Sign, and Nuchal Rigidity in Adults with Suspected Meningitis. Clin Infect Dis. (2002) 35 (1): 46-52.