Decorticate posture is an abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight. The arms are bent in toward the body and the wrists and fingers are bent and held on the chest.
This type of posturing is a sign of severe damage in the brain. People who have this condition should get medical attention right away.
Decorticate posture is a sign of damage to the nerve pathway between the brain and spinal cord. Although it is serious, it is usually not as serious as a type of abnormal posture called decerebrate posture.
The posturing may occur on 1 or both sides of the body.
Causes of decorticate posture include:
- Bleeding in the brain from any cause
- Brain stem tumor
- Brain problem due to drugs, poisoning, or infection
- Head injury
- Brain problem due to liver failure
- Increased pressure in the brain from any cause
- Primary brain tumor
- Secondary brain tumor
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 and treated right away in a hospital.
What to Expect at Your Office Visit
The person will receive emergency treatment. This includes getting a breathing tube and breathing assistance. The person will likely be admitted to the hospital and placed in the intensive care unit.
After the condition is stable, the provider will get a medical history from family members or friends and a more detailed physical examination will be done. This will include a careful examination of the brain and nervous system.
Medical history questions may include:
- When did this behavior start?
- Is there a pattern to the episodes?
- Is it always the same type of posture?
- Is there any history of a head injury or drug use?
- What other symptoms occurred before or with the abnormal posturing?
Tests that may be done include:
- Blood and urine tests to check blood counts, screen for drugs and toxic substances, and measure body chemicals and minerals
- Cerebral angiography (a dye and x-ray study of blood vessels in the brain)
- MRI or CT scan of the head
- EEG (brain wave testing)
- Intracranial pressure (ICP) monitoring
The outlook depends on the cause. There may be brain and nervous system injury and permanent brain damage, which can lead to:
- Inability to communicate
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Review Date: 6/1/2015
Reviewed By: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.