Meningeal Irritation : A Review

Cases of meningeal irritation are prevalent worldwide and much Infectious and non-infectiousaetiology exist for this condition. Sub-arachnoid haemorrhage (SAH), central nervous systemsarcoidosis(neuro-sarcoidosis) . systemic lupus erythematosus (SLE), drugs and chemicals arethe non-infectious causes of meningeal irritation. But much is focused on infectious causesbecause infection of the central nervous system (CMS) is a medical emergency. The clinicalconstellation of fever, headache and neck-stiffness is diagnostic of meningitis. Other clinicalfindings like Kernig's sign, Brudzinski's sign and extensor plantar responses support thediagnosis of meningitis and / or meningo-encephalitis. The clinical onset of sudden severeheadache, vomiting and unconsciousness is diagnostic of SAH. Neck rigidity, positive Kernig'ssign and sub-hyaloid haemorrhage on fundoscopic examination support the diagnosis.However, diagnosis of meningitis and its treatment is very much important and critical inparticular. A patient presenting with fever and unconsciousness with no substantial pre-existingillness eg. HTN, DM, endocrinopathy and.' or history of traveling from a malarial epidemic areashould be differentially considered meningo-encephalitis for once at least.doi: 10.3329/taj.v15i2.3922TAJ December 2002; Vol.15(2): 108-114