Meningismus

Meningismus - clinical syndrome that develops when the irritation of the meninges and characterized by headache, stiff neck, vomiting, and dizziness. Unlike meningitis (see), while meningism all these phenomena are expressed to a lesser extent, changes in the spinal fluid is not detected. The cause of meningism can be increased intracranial pressure, brain edema (with traumatic brain injury, coma, uremia). In infectious diseases phenomenon meningism depend on toxic irritation of the meninges. It should treat the underlying disease.

Meningismus (from the Greek. meninx, meningos brain membrane) - clinical manifestation irritation of the meninges. The term first proposed Dupre (that is, Dupre). Unlike true meningitis, meningeal symptoms when meningism expressed weakly. Persistent symptoms when meningism are headache, and a stiff neck; sometimes vomiting and dizziness; symptoms of Cernica - Brudzinskogo missing.
Meningismus can result from infection (usually influenza, pneumonia, measles, scarlet fever, typhus, typhoid fever), poisoning (coma, diabetes, uremia, food poisoning, occupational poisoning), brain injury after a lumbar puncture endolumbalno introduction of medicinal substances, with hypertension and other
Irritation of the meninges occurs usually due to acute coming of increased intracranial pressure, caused by increased production of cerebrospinal fluid, symptoms of hydrocephalus or acute edema and swelling of the membranes and substance of the brain. In General infection, especially in children, the production of cerebrospinal fluid is increased even mild inflammatory effects of shells and vascular plexuses. At the closed trauma of a skull with symptoms of concussion meningismus accompanied by edema and swelling of the brain; these can be in the initial period, and some time after the injury, if the patient does not comply with bed rest. The phenomenon of meningism can occur during a hypertensive crisis, when there spasms of blood vessels of the brain and membranes, acute edema and swelling of the brain. Sometimes after releasing large quantities of cerebrospinal fluid with lumbar puncture arise phenomena M or due to hyperemia of the meninges, or as a result of the so-called spinal fluid drainage, when there is a long lapse of cerebrospinal fluid in the epidural space.
Diagnosis M is based on the study of spinal fluid, reduced meningeal syndrome (see Meningitis) and quite rapid disappearance of symptoms. At the puncture of the spinal fluid is allocated under high pressure, the composition of its normal, but sometimes in the beginning of the disease may occur small Placitas, who quickly disappears. The amount of protein is usually within normal limits. Differential diagnosis of meningism not always easy, it is especially difficult with suspected tuberculous meningitis in the initial period, when there is no pleocytosis and meningeal symptoms still not expressed (Doctor S. Footer). In these cases, the correct diagnosis can help the appearance of a fibrinous film, reduction of sugar and chlorides in the spinal fluid. Sometimes it can be difficult to differentiate M. with acute lymphocytic choriomeningitis in which cerebrospinal fluid protein may not be increased, and the number of cells in the beginning of the disease is low. The correct diagnosis in these cases helps acute onset, high fever and expressed meningeal syndrome in M. these symptoms disappear quickly.
Treatment of meningism is treatment of the underlying disease and the measures aimed at reducing intracranial pressure. In most cases, a lumbar puncture (see Lumbar puncture) gives fast therapeutic effect. Due to the presence of phenomena edema and swelling of the brain and its meninges recommended intravenous infusion of hypertonic solutions, intramuscularly - novoryt, Mercosul, inside - 3% solution amidopirina.