During the past several decades, researchers have shown that the eponymous signs of meningitis have reduced sensitivity and specificity compared with when they were originally described. This may be because of the changing epidemiology of meningitis and its treatment or it may be because of variations in performance of the maneuvers. For example, in the original descriptions, the Kernig sign (resistance of leg extension) is best elicited with the patient sitting and the Brudzinski nape of the neck sign involves holding down the patient’s chest as the neck is flexed. These and other lesser-known signs of meningitis by Amoss, Bikeles and Edelmann all relate to the mechanics of stretching inflamed meninges, and this review will allow the clinician to understand how the history related to these maneuvers is still germane to clinical practice today.
From the Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Accepted for publication December 26, 2015.
The author has no funding or conflicts of interest to disclose.
Address for correspondence: Sarah E. Forgie, MD, MEd, Department of Pediatrics, University of Alberta, 3-588D Edmonton Clinic Health Academy, 1405 87 Ave, Edmonton, AB, T6G 1C9 Canada. E-mail: firstname.lastname@example.org.