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Decerebrate posture

Decerebrate posture is an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backwards. The muscles are tightened and held rigidly. This type of posturing usually means there has been severe damage to the brain.

Considerations

A severe injury to the brain is the usual cause of decerebrate posture.

Opisthotonos (a severe muscle spasm of the neck and back) may occur in severe cases of decerebrate posture.

Decerebrate posture can occur on one side, on both sides, or in just the arms. It may alternate with decorticate posture . A person can also have decorticate posture on one side of the body and decerebrate posture on the other side.

Causes

Home Care

Conditions related to decerebrate posture need to be treated right away in a hospital.

When to Contact a Medical Professional

Abnormal posturing of any kind usually occurs with a reduced level of alertness. Anyone who has an abnormal posture should be examined right away by a health care provider.

What to Expect at Your Office Visit

The person will need emergency treatment right away. This includes breathing assistance and placement of a breathing tube. The person will likely be admitted to the hospital and placed in intensive care.

Once the person is stable, the health care provider will obtain a complete medical history from family members or friends and do a more complete physical examination, including a brain and nervous system assessment.

Family members will be asked questions about the person's medical history, including:

  • When did this behavior start?
  • Is there a pattern to the occurrences?
  • Is it always the same type of posture?
  • Is there any history of a head injury or other condition?
  • What other symptoms came before or with the abnormal posturing?

Tests may include:

The outlook depends on the cause. There may be brain and nervous system injury and permanent brain damage, which can lead to:

  • Coma
  • Inability to communicate
  • Paralysis
  • Seizures

References

Mayer SA, Badjatia N. Head injury. In: Wolfson AB, Hendey GW, Ling LJ, et al, eds. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 70.

Brust JCM Coma. In Rowland LP, Merritt HH, eds. Merritt's Neurology. 12th ed. Baltimore, Md: Lippincott Williams & Wilkins; 2009:chap 6.

Updated: 4/5/2013

Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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