The specificity of jolt accentuation was 82%, Kernig sign was 97%, Brudzinski sign was 98%, and nuchal rigidity was 80%. Jolt accentuation in our cohort was poorly predictive of pleocytosis and insensitive. The presence of Kernig sign, Brudzinski sign, or nuchal rigidity has moderate positive but no negative predictive value for pleocytosis.. Early symptoms will be similar to the flu, and they can develop over a matter of hours or even days. Symptoms include: sudden high fever. stiff neck. severe headache. nausea or vomiting. confusion.
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Brudzinski sign occurs in meningitis (of any etiology) or meningism where passive flexion of a patient’s neck elicits reflexive bilateral knee and hip flexion; it was originally known as the “nape of the neck sign” and was one of several physical exam maneuvers concurrently described to be characteristic of meningitis. Along with Kernig sign.. In 1909, Brudzinski reported that, for patients with bacterial or tuberculous meningitis, Kernig’s sign was 57% sensitive, and Brudzinski’s nape-of-the-neck sign was 96% sensitive . Since then, the presence of these clinical signs has been interpreted as evidence of meningeal inflammation.
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