BrudziƄski's sign

BrudziƄski's sign or a BrudziƄski sign is any of three medical signs, all of which may occur in meningitis or meningism. All three are named after JĂłzef BrudziƄski.[1] In English, the name is often written without the diacritic (like many borrowed words) (Brudzinski) and is pronounced /bruːˈdʒÉȘnski/.

BrudziƄski's sign
Differential diagnosisMeningitis, Meningism

BrudziƄski cheek sign

The BrudziƄski cheek sign or BrudziƄski's cheek phenomenon is a clinical sign in which pressure on the cheek elicits a reflex action, usually a twitching of the area near the eye or upper lip, and flexion of the forearm when pressure is applied to upper arm with a sphygmomanometer. It is found in patients with meningitis, and is analogous to the BrudziƄski symphyseal sign in the lower limb.[2][1]

BrudziƄski symphyseal sign

The BrudziƄski symphyseal sign is a clinical sign in which pressure on the pubic symphysis elicits a reflex flexion of the hip and knee, and abduction of the leg. It is found in patients with meningitis, and is analogous to the BrudziƄski cheek sign in the upper limb.[2][1]

This sign was also independently discovered by a Brazilian Clinician, by the name of AloĂ­sio De Castro (1881-1959) in 1912, and is commonly called as the AloĂ­sio De Castro's Sign in Brazil.[3]

BrudziƄski neck sign

The BrudziƄski neck sign or BrudziƄski's symptom is a clinical sign in which forced flexion of the neck elicits a reflex flexion of the hips. It is found in patients with meningitis,[2][1] subarachnoid haemorrhage and possibly encephalitis. It is not very commonly seen.

Pathophysiology

The pain felt on Kernig's sign is due to meningeal irritation caused by movement of the spinal cord within the meninges.[4] In the Brudzinski's neck sign, this movement with neck flexion is cancelled out by the flexion of the hip; much like two persons pulling on either side of a single rope.[1]

See also

References

  1. Ward MA, Greenwood TM, Kumar DR, Mazza JJ, Yale SH (March 2010). "Josef Brudzinski and Vladimir Mikhailovich Kernig: signs for diagnosing meningitis". Clinical Medicine & Research. 8 (1): 13–7. doi:10.3121/cmr.2010.862. PMC 2842389. PMID 20305144.
  2. BrudziƄski, Józef (1908). "Ueber die Kontralateralen Reflexe an den Unteren Extremitaeten bei Kindern" [A New Sign of the Lower Extremities in Meningitis of Children]. Wien Klin Wschr. 21: 255–61.
  3. "Aloysio de Castro - NeglectedScience". www.neglectedscience.com. Retrieved 2018-03-09.
  4. Thomas KE, Hasbun R, Jekel J, Quagliarello VJ (July 2002). "The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis". Clinical Infectious Diseases. 35 (1): 46–52. doi:10.1086/340979. PMID 12060874.
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