Brudzinski sign

Brudzinski's sign is a clinical sign in neurology, used in the diagnosis of meningitis. It was named after the Polish neurologist, Józef Brudziński.

Definition

Brudzinski's sign is a physical examination finding during a meningeal irritation test. It is elicited by forcefully flexing the patient's neck. A positive sign is noted when this maneuver results in involuntary flexion of the hips and knees.

Clinical significance

Brudzinski's sign is one of the physically demonstrable symptoms of meningitis, which is an inflammation of the meninges, the protective membranes of the brain and spinal cord. The presence of Brudzinski's sign suggests irritation of the meninges and can be a clue in the diagnosis of conditions such as bacterial or viral meningitis.

Limitations

While a positive Brudzinski's sign can be indicative of meningitis, it is not definitive. Other clinical signs and symptoms, as well as laboratory tests, are needed to confirm the diagnosis. Furthermore, the absence of Brudzinski's sign does not rule out meningitis.

See also

• Kernig's sign
• Meningitis
• Neurological examination

References

• Brudziński J. (1909). Ein neues Symptom der Meningitis. Berliner klinische Wochenschrift, 46: 765–767.
• van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. (2004). Clinical features and prognostic factors in adults with bacterial meningitis. New England Journal of Medicine, 351: 1849–1859.