Q: What is a "jolt accentuation maneuver" to rule out meningitis?
Answer: Kernig's sign and Brudzinski's sign are well-known in Meningitis. The "jolt accentuation maneuver" also helps to rule out meningitis in patients with fever and headache. The patient is instructed to rapidly rotate their head horizontally; if this does not worsen the headache, meningitis is unlikely.
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Recommended readings:
1. Afhami S, Dehghan Manshadi SA, Rezahosseini O. Jolt accentuation of headache: can this maneuver rule out acute meningitis? BMC Res Notes. 2017 Oct 30;10(1):540. doi: 10.1186/s13104-017-2877-1. PMID: 29084605; PMCID: PMC5663092.
2. Iguchi M, Noguchi Y, Yamamoto S, Tanaka Y, Tsujimoto H. Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting. Cochrane Database Syst Rev. 2020 Jun 11;6(6):CD012824. doi: 10.1002/14651858.CD012824.pub2. PMID: 32524581; PMCID: PMC7386453.
3. Akaishi T, Kobayashi J, Abe M, Ishizawa K, Nakashima I, Aoki M, Ishii T. Sensitivity and specificity of meningeal signs in patients with meningitis. J Gen Fam Med. 2019 Jul 15;20(5):193-198. doi: 10.1002/jgf2.268. PMID: 31516806; PMCID: PMC6732499.
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