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Decerebrate and decorticate posturing are strongly associated with poor outcome in a variety of conditions. For example, near-drowning patients who display decerebrate or decorticate posturing have worse outcomes than those who do not. [3] Changes in the condition of the patient may cause alternation between different types of posturing. [4]
Decorticate posturing, with elbows, wrists and fingers flexed, and legs extended and rotated inward. Brain herniation frequently presents with abnormal posturing, [2] a characteristic positioning of the limbs indicative of severe brain damage.
Tonic posturing preceding convulsion has been observed in sports injuries at the moment of impact [2] [3] where extension and flexion of opposite arms occur despite body position or gravity. The fencing response emerges from the separation of tonic posturing from convulsion and refines the tonic posturing phase as an immediate forearm motor ...
Decorticate posturing is a stereotypical posturing in which the patient has arms flexed at the elbow, and arms adducted toward the body, with both legs extended. Decerebrate posturing is a stereotypical posturing in which the legs are similarly extended (stretched), but the arms are also stretched (extended at the elbow). The posturing is ...
Paralysis/hemiparesis (acquired causes such as post-stroke, post-neurological injury; congenital/innate such as cerebral palsy) Makes no movements Abnormal extension (decerebrate posture) [b] Abnormal flexion (decorticate posture) Flexion / Withdrawal from painful stimuli Moves to localise pain Obeys commands
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Brainstem damage above the red nucleus level may cause decorticate rigidity. Responding to a startling or painful stimulus, the arms flex and the legs extend. The cause is the red nucleus, via the rubrospinal tract, counteracting the extensor motorneuron's excitation from the lateral vestibulospinal and reticulospinal tracts.
In humans, true decerebrate rigidity is rare since the damage to the brain centers it might be caused by usually are lethal. However, decorticate rigidity can be caused by bleeding in the internal capsule which causes damage to upper motor neurons. The symptoms of decorticate rigidity are flexion in the upper limbs and extension in the lower limbs.