Brudzinski's sign and Kernig's sign are always abnormal in meningitis.

• A. True
• B. False
• C. Only in infants
• D. They are never abnormal

Answer: (A)

Brudzinski and Kernig signs reflect irritation of the meninges and are classic indicators when meningitis is present. A positive Brudzinski sign occurs when neck flexion triggers involuntary flexion of the hips and knees, showing that meningeal irritation is provoking a reflexive response. A positive Kernig sign happens when the hip is flexed to 90 degrees and attempting to straighten the knee produces pain and resistance, again signaling meningeal irritation.

These signs are abnormal in meningitis because the inflamed meninges sensitize the nerve roots and surrounding structures, leading to pain and reflexive movements when these maneuvers are performed. Clinically, their presence supports the diagnosis of meningitis.

Keep in mind that no single sign is perfectly sensitive or specific, so absence does not completely rule out meningitis, and signs may be less reliable in certain populations (like very young or elderly patients) or early in the disease. Still, when these signs are observed, they align with meningitis, making the statement true.