This retrospective study evaluated the utility of jolt accentuation of headache (JAH) and other clinical signs in detecting herpes zoster (HZ)-associated meningitis. Among 70 HZ patients, 17 had meningitis, and JAH was present in 29.4% of them versus 3.8% without meningitis, showing high specificity ( 96% ) but low sensitivity ( 29% ). Other symptoms— fever, nausea/vomiting, headache in areas without rash, neck stiffness, altered mental status, and paralysis—showed similar patterns.
The study highlights that while JAH is highly specific , it is insufficiently sensitive, emphasizing the need for comprehensive clinical assessment and CSF testing when meningeal signs are present. These findings are significant as they guide clinicians in early recognition of HZ-associated meningitis despite the subtle presentation of meningeal irritation. ##Reference## Tanaka T, Umezaki M, Kameyama T, et…
