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Topic: Nuchal rigidity

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	Meningism - Wikipedia, the free encyclopedia
		Meningism is the triad of nuchal rigidity, photophobia (intolerance of bright light) and headache.
		It is a sign of irritation of the meninges, such as seen in meningitis, subarachnoid hemorrhages and various other diseases.
		Nuchal rigidity is the inability to flex the head forward due to rigidity of the neck muscles.
	en.wikipedia.org /wiki/Meningism (166 words)

	nuchal rigidity information. (Site not responding. Last check: 2007-10-31)
		Meningism is the triad of nuchal rigidity, photophobia (intolerance of bright..
		Nuchal rigidity is the the inability to flex the head forward due to..
		definite nuchal rigidity, coma) and warn that nuchal rigidity may not be as strong a..
	www.indel.ru /n/nuchal_rigidity.html (209 words)

	Subarachnoid hemorrhage - Wikipedia, the free encyclopedia
		Grade 1: Asymptomatic; or minimal headache and slight nuchal rigidity.
		Grade 2: Moderate to severe headache; nuchal rigidity; no neurologic deficit except cranial nerve palsy.
		Grade 4: Stuporous; moderate to severe hemiparesis; possibly early decerebrate rigidity and vegetative disturbances.
	en.wikipedia.org /wiki/Subarachnoid_hemorrhage (855 words)

	eMedicine - Tetanus : Article Excerpt by: Eleftherios Mylonakis, MD, PhD
		The muscular rigidity is caused by a dysfunction in the interneurons that inhibit the alpha motor neurons of the affected muscles.
		Nuchal rigidity and dysphagia also are early complaints that cause risus sardonicus, the ironic smile of tetanus, resulting from facial muscle involvement.
		As the disease progresses, patients have generalized muscle rigidity with intermittent reflex spasms in response to stimuli (ie, noise, touch).
	www.emedicine.com /med/byname/tetanus.htm (727 words)

	Discovery Health :: Diseases & Conditions :: neck stiffness (Site not responding. Last check: 2007-10-31)
		A stiff neck refers to a tightness or rigidity in the muscles supporting the neck.
		Nuchal rigidity refers to a stiffness that prevents bending of the neck and limits movement of the neck.
		If the neck stiffness is due to a major injury or head trauma or if there is severe nuchal rigidity, emergency treatment may be needed.
	health.discovery.com /encyclopedias/illnesses.html?article=3155&page=1 (831 words)

	emrupdate.com - Illegal Immigrant with rash, fever, nuchal rigidity. (Site not responding. Last check: 2007-10-31)
		He had nuchal rigidity (he could not straighten his neck).
		Re: Illegal Immigrant with rash, fever, nuchal rigidity.
		What brought him in was the most pronounced and severe symptoms- the fever and the nuchal rigidity.
	www.emrupdate.com /forums/thread/48238.aspx (1301 words)

	Poor Grade Subarachnoid-Hemorrhage>
		Grade I patients have minimal headache or slight nuchal rigidity; grade II patients have moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy; grade III patients are drowsy, confused, or have mild focal neurologic deficits.
		Patients in grade IV neurologic condition are those who are stuporous with moderate to severe hemiparesis, possibly early decerebrate rigidity, and vegetative disturbances.
		Grade V patients are those in deep coma with decerebrate rigidity or a moribund appearance.
	neurosurgery.mgh.harvard.edu /neurovascular/v-s-93-2.htm (949 words)

	The Medicine Journal - September 2001- Neonatal Meningitis (Site not responding. Last check: 2007-10-31)
		Fever (94%), vomiting (82%), and nuchal rigidity (77%) are the most common presenting symptoms of meningitis in children 1 to 4 years of age, with many also experiencing lethargy, irritability, vomiting anorexia and photophobia.
		Nuchal rigidity is absent throughout the course in 1,5% of infants and children and generally is less prominent in the younger child.
		Of interest is the observation that only 16%, of children presenting with symptoms suggestive of CNS infection and in whom a lumbar puncture is performed, will have abnormal CSF findings and only about 1/3 of these patients with abnormal CSF will have proven bacterial meningitis.
	www.medpharm.co.za /safp/2001/sept/neonatal.html (593 words)

	eMedicine - Tetanus : Article by Eleftherios Mylonakis, MD, PhD
		Synonyms and related keywords: tetanus, lockjaw, nuchal rigidity, dysphagia, risus sardonicus, Clostridium tetani, C tetani, tetanus neonatorum, trismus nascentium, umbilical sepsis, generalized tetanus, local tetanus, cephalic tetanus, neonatal tetanus, tetanolysin, tetanospasmin
		The initial manifestation may be local tetanus, in which the rigidity affects only 1 limb or area of the body where the clostridium-containing wound is located.
		Severe tetanus results in opisthotonos, flexion of the arms, extension of the legs, periods of apnea resulting from spasm of the intercostal muscles and diaphragm, and rigidity of the abdominal wall.
	www.emedicine.com /MED/topic2254.htm (2973 words)

	Febrile seizures : Epilepsy.com/Professionals
		In contrast, 90% of seizures secondary to meningitis are followed by postictal stupor, and most of the remaining 10% demonstrate other meningitic signs, such as nuchal rigidity.
		Because up to 30% of children with bacterial meningitis have a seizure, it is frequently taught that lumbar puncture (LP) is mandatory for children who have fever and seizure, because the convulsion may be the sole manifestation of bacterial meningitis.
		They found that meningitis was associated with seizures in 23% of cases, but all of these patients presented with signs in addition to the fever and seizure.
	professionals.epilepsy.com /wi/print_section.php?section=infectious_febrile (715 words)

	Neurological Exam: Spinal Cord: Lesions: Degenerative Diseases - Poliomyelitis (Site not responding. Last check: 2007-10-31)
		A Sample Case: In the days before the polio vaccine, a 9 year old boy developed fever, headache, malaise, stiff neck, and increasing weakness of the left arm.
		He was admitted to the hospital where examination revealed nuchal rigidity, a flaccid paresis with muscle fasciculation, hypotonia and hyporeflexia of the left upper extremity which was most pronounced in the biceps and deltoid muscles.
		Stiffness of the neck on forward flexion (nuchal rigidity) indicates inflammation of the meninges.
	isc.temple.edu /neuroanatomy/lab/lesions/6.htm (232 words)

	Best Practice of Medicine -Viral Encephalitis (including the West Nile virus) - Print Report (Site not responding. Last check: 2007-10-31)
		Affected patients typically have an abrupt onset of fever, depression of consciousness, mild nuchal rigidity, and variable multifocal neurologic abnormalities.
		Nuchal rigidity is expected in viral meningitis and is often present in viral encephalitis (thus, appropriately termed meningoencephalitis).
		Nuchal rigidity is typically pronounced in bacterial meningitis, may be noted only at extreme neck flexion in viral meningitis or meningoencephalitis, and by definition is absent in patients with "only" encephalitis.
	merck.micromedex.com /index.asp?page=bpm_viewall&article_id=BPM01ID01&show_banner=no (10785 words)

	Teaching File Case#15 (Site not responding. Last check: 2007-10-31)
		Clinical Information: This two-year-old male, presenting originally with fever/rule out sepsis @ an outside hospital, is now transfered to Children's Hospital with nuchal rigidity and severe obtundation.
		Clinical presentation of tuberculous meningitis may differ from more common/typical pyogenic bacterial meningitis in that fever may be initially absent or low grade according to some reports.
		Headache and nuchal rigidity may also be seen less common upon first presentation.
	www.uab.edu /pedradpath/case15.html (497 words)

	Human Rabies --- Tennessee, 2002
		The nuchal skin biopsy was negative for rabies virus antigen by the direct fluorescent antibody test.
		The nuchal skin biopsy and saliva from August 29 were positive for rabies virus RNA by reverse transcription polymerase chain reaction.
		The virus was identified by genetic sequence analysis as a variant associated with silver-haired and eastern pipistrelle bats.
	www.cdc.gov /mmwr/preview/mmwrhtml/mm5137a2.htm (1349 words)

	Case Vignettes in Neurology
		Her examination is significant for cough, mild dehydration, somnolence, a temperature of 39C, and nuchal rigidity.
		C, nuchal rigidity, bilateral papilledema, and decreased upgaze.
		There is a mild increase in tone in the lower extremities, increased knee jerk and ankle jerk reflexes, and bilateral Babinski signs.
	medocs.ucdavis.edu /neu/420/cases/cases99/CASE28.HTM (1154 words)

	Radiology In Ped Emerg Med, Vol 7, Case 9
		She also develops tonic-clonic movements of her left upper extremity, and is therefore given a IV lorazepam followed by phenytoin.
		Because of the infant's fever, nuchal rigidity, lethargy, and focal neurologic abnormalities, a diagnosis of meningitis and/or encephalitis is suspected.
		In general, a patient with encephalitis presents with diffuse or focal neurologic signs and symptoms, including an altered mental state and level of consciousness, behavioral or personality changes, nuchal rigidity, photophobia, and generalized or focal seizures.
	www.hawaii.edu /medicine/pediatrics/pemxray/v7c09.html (3508 words)

	AEGiS-13IAC: Cryptococcosis in HIV-1 infected children.
		At the onset of c.i, 10 children were in stage B and 5 children in stage C. The median of CD4 cells count was 70/il.
		Clinical characteristics were headache (11 cases), fever (11 cases), seizures (10 cases), changes in mental status (9 cases), nuchal rigidity (8 cases), focal neurological signs (5 cases), malaise (5 cases), myalgia (4 cases).
		Headaches, fever, seizures and changes in mental status were the predominant symptoms; only half of the children had nuchal rigidity.3.The prevalence of c.i.
	www.aegis.com /conferences/iac/2000/MoPeB2299.html (401 words)

	Rigidity - OneLook Dictionary Search
		Rigidity : Online Plain Text English Dictionary [home, info]
		Phrases that include Rigidity: modulus of rigidity, catatonic rigidity, nuchal rigidity, postmortem rigidity, clasp-knife rigidity, more...
		Words similar to Rigidity: inflexibility, rigidities, rigidness, more...
	www.onelook.com /?w=Rigidity (222 words)

	Dr. Floyd's Lecture
		Headache with fever and signs of meningeal irritation (nuchal rigidity and Brudzinski's sign) strongly suggests infection which must be ruled out without delay; however, neonates or elderly individuals with central nervous system infection may not be able to report headache and fever, and signs of meningeal irritation may be absent.
		Lack of sufficient immunologic maturity to mount adequate immune response allows local infections to become disseminated to central nervous system; presenting signs and symptoms are non-specific (such as irritability, poor feeding, cyanosis, jitteriness, or lethargy); nuchal rigidity does not occur; fever is uncommon, and infected infant often is hypothermic.
		Infection by organisms of femal genital tract is acquired during passage through birth canal; such organisms include: enteric gram-negative rods (particularly Escherichia coli), group B B-hemolytic streptococci, and Listeria monocytogenes; such infections usually present during first week of life.
	www.kcom.edu /faculty/chamberlain/website/tritzid/floyd.htm (2280 words)

	Meningitis, Community-Acquired, Adult - Evanston Northwestern Healthcare
		Patients present with fever, headache, nausea, vomiting, and nuchal rigidity.
		In a prospective study by Thomas KE, et al, the 3 classic meningeal signs (Kernig's sign, Brudzinski's sign, and nuchal rigidity) were of limited clinical diagnostic value for adults with suspected meningitis.
		Thomas KE, Hasbun R, Jekel J, et al, “The Diagnostic Accuracy of Kernig's Sign, Brudzinski's Sign, and Nuchal Rigidity in Adults With Suspected Meningitis,”Clin Infect Dis, 2002, 35(1):46-52.
	www.enh.org /healthandwellness/bioterrorism/bi001600.aspx?lid=1093 (294 words)

	Medicine (Site not responding. Last check: 2007-10-31)
		The story is compelling, relates to current events, and is chock full of human interest. I'm glad the guy is OK. In my imagination, I had him down for multiple insect, leech, and snake bites, poison ivy, and a light dusting of birdshot.
		It was good of you to help this person. Re: Illegal Immigrant with rash, fever, nuchal rigidity.
		Actually I did mean variola - smallpox, and I was just kidding. Chickenpox from memory usually has lesions at different stages of development, whereas you described them all at the same stage.andnbsp; It is, however, more truncal like your case.
	www.emrupdate.com /forums/rss.aspx?ForumID=10&PostID=48238 (998 words)

	The Brain Attack Coalition: Initial Evaluation of Suspected Subarachnoid Hemorrhage (October 1996)
		Arrange for speedy triage and referral of patients with SAH to a neurosurgical center.
		The sudden onset of the "worst-ever" headache with transient impairment ofconsciousness followed by nausea, vomiting, nuchal rigidity, and focal neurological signsis the classic presentation of SAH.
		A CT scan of the brain without contrast is the diagnostic procedure of choice for suspected SAH and should be obtained urgently.
	www.stroke-site.org /guidelines/kaiser_initial.html (484 words)

	University of Florida Department of Neurosurgery Patient Information Page
		The symptoms of a ruptured cerebral aneurysm are graded using the Hunt and Hess scale of subarachnoid hemorrhage severity:
		Grade 1: Asymptomatic; or minimal headache and slight nuchal (neck) rigidity.
		The diagnosis of a cerebral aneurysm is made using neuroimaging modalities.
	www.neurosurgery.ufl.edu /Patients/aneurysm.html (910 words)

	Sick Baby
		You try to bend her neck forward and find that it is very difficult to do so.
		This nuchal rigidity (stiff neck) is a sign of?
		The physical explanation of the nuchal rigidity in meningitis is? Bugs Database
	medinfo.ufl.edu /year2/mmid/bms5300/cases/a21aq.html (530 words)

	Nursebob’s MICU/CCU Survival Guide
		I Asymptomatic, or mild headache and slight nuchal rigidity
		II Cranial nerve (CN) palsy (for example, CN III – oculomotor, CN VII – abducens, moderate to severe headache, nuchal rigidity
		IV Stupor, moderate to severe hemiparesis, early decerebrate rigidity
	rnbob.tripod.com /subarachnoidhemorrhage.htm (113 words)

	Headache
		This video shows nuchal rigidity with inability to put chin to chest, positive Kernigs sign with pain on knee extension when the hip is flexed and positive Brudzinskis sign with automatic knee and hip flexion with passive neck flexion.
		How specific are Kernigs and Brudzinskis signs and how helpful is the presence of nuchal rigidity in making the diagnosis of meningitis?
		In multiple studies nuchal rigidity in meningitis has a pooled sensitivity of 70%.
	www.med-ed.virginia.edu /courses/fm/headache/LRogers.cfm (714 words)

	[No title] (Site not responding. Last check: 2007-10-31)
		Asymptomatic or minimal headache and slight nuchal rigidity
		Grade II Moderate-to-severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve
		Stupor, moderate-to-severe hemiparesis; possible early decerebrate rigidity, and vegetative disturbances
	www.nursingsociety.org /education/SA0002_add.html (77 words)

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