Description and Possible Medical Problems
The last time you spent the night away from home and without the pillow it’s taken you years to mold just right, you may have woken up with a stiff neck and maybe even a headache. The stiffness may have subsided as the day proceeded, but you were bound to be greeted by the same discomfort when you woke up the next morning, until you got back home and back to your pillow.
One kind of neck stiffness isn’t so easy to fix, and, in fact, is a sign of a serious problem. If your neck is stiff when you try to move your head up and down and you have a headache and fever and feel nauseous, you may have meningitis, which is an inflammation of the lining of the brain. If the stiffness occurs when you try to move your head from side to side and you also feel achy, you may have a variation of meningitis called meningismus. This condition differs from meningitis in that it appears to originate from spasms in the muscles of the neck, not from an infection in the brain. Also, while one sign of meningitis is stiffness when you try to touch your chest with your chin, the primary characteristic of meningismus is overall aches and pains.
Though meningitis is usually caused by a virus, it can also be caused by bacteria. Bacterial meningitis tends to be more severe and therefore more serious than meningitis that is caused by a virus. While the symptoms of bacterial meningitis and viral meningitis are initially similar, with bacterial meningitis you’ll eventually appear more confused and have a higher fever than with viral meningitis. In addition to the other symptoms, it’s possible that you may also have encephalitis, which is an inflammation of the brain itself.
To diagnose meningitis, your doctor will need to perform a spinal tap and sometimes will also order a CAT scan (for a description of the procedure, see the treatment under “Headache in the Morning, Made Worse by Sneezing, Coughing,” above). If the cause is due to bacteria, the treatment will be with antibiotics, and you may need to be hospitalized. If the meningitis is viral in origin even though it may not be severe, you may need to be hospitalized anyway to make sure that you are properly hydrated and treated with an antiviral medication. With proper rest, lots of liquids, and proper medication, recovery usually takes two to three weeks. If you are also diagnosed with encephalitis, the treatments prescribed for meningitis will also help ease the symptoms of encephalitis. Your doctor may also prescribe a corticosteroid preparation like prednisone to reduce the inflammation.