Meningitis and meningeal syndrome in children
Meningitis???? What is it? Well, the brain and the spinal cord is covered by a layer and that particular layer is called meninges. So, the inflammation of this layer I.e. meninges is called meningitis. It is a very severe disease with high mortality in children of early age.
The clinical symptoms arising due to the affection of meninges (inflammatory and non-inflammatory genesis), is referred to as a meningeal syndrome. It’s most frequent signs are:
- Headache – In children of early age, it is monotonous, i.e. monotonous with regard to the sound of their cry.
- Nausea, vomiting in small children, protrusion and pulsation of the frontal fontanels is a very significant sign for the pediatrician.
- General hyperesthesia – a painless touch of the skin of the child is accompanied by his getting anxious, crying, shouting.
- Rigidity of occipital muscles – the doctor can’t bend the head of the patient forward. For the designation of this symptom one hand is placed on the chest and another on the backside of the head. Then simultaneously the chest is pressed downwards and the head upwards. Force of resistance should be determined.
- Meningeal position – the head is thrown back, legs are pressed to the abdomen, the child lies on one side.
- Kerning’s symptom– if the kerning reflex is present in the child after 4 months of age, it is a sign of pathology.
- Brzezinski’s symptom (polish pediatrician)
- Higher – the doctor bends the head of the patient forward, during this the legs are bent spontaneously in the knee and hip joints.
- Middle – In reply to pressing above the pubis the lower limbs bend as described above.
- Lower – In response to the flexion of one leg by the doctor in the knee and hip joint, the patient bends his other leg in knee and hip joints.
- Zygotic– In response to the pressing of the cheekbone the child raises his shoulders and flexes his/her hands in the elbow joints (characteristic of tubercular meningitis)
- Lesage’s symptom – when the child is lifted up by holding him/her under the arms the legs are bent towards the abdomen.
The dissociation of the meningeal syndrome is characteristic of meningioma, which means while one symptom is present others may be absent.