Kernig's Sign

Original Editor ­ Oyemi Sillo

Top Contributors - Oyemi Sillo, Kim Jackson, Evan Thomas and Daphne Jackson

Description

Kernig's sign is one of the physically demonstrable symptoms of meningitis. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.[1]

Purpose

An indicator of meningitis.[2]

Technique[3]

To elicit the Kernig's sign

  • The patient is positioned in supine with hip and knee flexed to 90 degrees,
  • The knee is then slowly extended by the examiner (Repeat on both legs)
  • Resistance or pain and the inability to extend the patient's knee beyond 135 degrees, because of pain, bilaterally indicates a positive Kernig's sign

Evidence

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.

Manmohan Mehndiratta, Rajeev Nayak, Hitesh Garg, Munish Kumar, and Sanjay Pandey.Appraisal of Kernig's and Brudzinski's sign in meningitis.  Ann Indian Acad Neurol. 2012 Oct-Dec; 15(4): 287–288.

Thirunavukkarasu Arun Babu. Improved sensitivity of Kernig's and Brudzinski's sign in diagnosing meningitis in children.  Ann Indian Acad Neurol. 2013 Jul-Sep; 16(3): 460–461.


References

  1. http://www.nlm.nih.gov/medlineplus/ency/imagepages/19077.htm
  2. Introduction to Emergency Medicine edited by Elizabeth Mitchell, Ron Medzon. Lippincott Williams & Wilkins, 2005
  3. Brunner & Suddarth's Textbook of Medical-surgical Nursing, Volume 1. edited by Suzanne C. O'Connell Smeltzer, Brenda G. Bare, Janice L. Hinkle, Kerry H. Cheever. Lippincott Williams & Wilkins, 2010