Kernig's and Brudzinski's signs revisited

Although meningitis has been recognized since antiquity, the clear description of signs of meningeal irritation is relatively recent. Kernig's sign is described in physical diagnosis texts; however, the test for Kernig's sign as currently performed differs from Kernig's original description. Brudzinski described several signs of meningitis; his "nape of the neck" sign is the best known. The contralateral leg signs described by Brudzinski are unfamiliar to most clinicians. Brudzinski believed that knowledge of all the meningeal signs was of use because some may be present while others are absent. Since outcome in meningitis is dependent on early treatment--and therefore early diagnosis--familiarity with all the meningeal signs is desirable.