Purpose of Brudziński’s obscure cheek sign: To determine if the patient has inflammation of the meninges (meningitis) (1).

Patient position: Lying supine.

Examiner position: Standing beside the bed, facing the patient.

Procedure: With the patient lying supine, apply pressure on both cheeks of the patient, inferior to the zygomatic arch.

Outcome: Brudziński’s sign is a sign of meningeal irritation. If meningeal irritation is present, this manoeuvre causes involuntary flexion of the patient’s forearm and arm. This is a positive Brudzinski’s obscure cheek sign (1). 

References:

1. Brudzinski J. Ueber die Kontralateralen Reflexe an den Unteren Extremitaeten bei Kindern. Wien Klin Wschr. 1908;21:255 – 61.
2. Verghese A, Gallemore G. Kernig’s and Brudzinski’s signs revisited. Reviews of infectious diseases. 1987;9(6):1187-92.