What is meningeal irritation sign?

The three major manifestations of meningeal irritation are neck stiffness, positive Koenig sign, and positive Brookings sign, which involve nervous system responses and meningeal irritation. 1. Neck stiffness When performing the neck flexion test, patients may exhibit varying degrees of neck stiffness. This means that resistance is encountered when attempting to bend the neck, and even passive movements in other directions may be limited. Note, however, that neck stiffness is not limited to meningeal irritation signs; it may also be a symptom of other conditions such as cervical spondylosis. 2. Positive Koenig sign When the patient is supine, the doctor bends one hip at a right angle and then tries to straighten the knee. The test is positive if the angle between the thigh and calf does not reach 135 degrees and the patient experiences pain or spasms in the retroosseous muscles. However, this sign is not absolutely specific, as similar reactions may occur in conditions such as sciatica. 3. Positive Brookings sign When the patient flexes the neck, both hips and knees flex. Further, when one hip flexes, the other leg flexes. These signs are important in meningeal irritation, but may also be associated with other neurological disorders. Therefore, these signs need to be interpreted taking into account the overall clinical situation of the patient.