How to examine signs of meningeal irritation (SOMI)? Many of you do not perform the exact method, I bet! Do you?
Signs of meningeal irritation include three signs: neck stiffness, Kernig's sign and Brudzinski's sign.
Neck Stiffness
Take away the pillow and put the bench flat. Make sure that the
patient's lower limbs are exposed and fully extended. Lift the head of
the patient with fingers on the occiput and use the ulnar border of your
hands to feel the spasm in the neck. Gently flex the head until the
chin touches the chest. Ask the patient to hold his/her neck for 10
seconds.
Kernig's Sign
"Flex one lower limb at hip and knee with your left hand on the medial hemstrings. The sign is present when the extension is resisted by the spasm in the hemstrings. There may also be the reflex flexion in the opposite limb. Kernig's sign is not present in the local causes of neck stiffness such as cervical spine disease and raised intracranial pressure (ICP).
Brudzinski's Sign
It is an addition to the test for neck stiffness. See the maneuver for neck stiffness. When the head is lifted and flexed towards chest, the patient flexes his/her lower limbs at hip and knee joints.
Keywords: Signs of meningeal irritation, SOMI, Neck stiffness, Neck rigidity, Kernig's sign, Brudzinski's sign, Meningitis, Examination of meningeal irritation, SOMI stands for,
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