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{{Abnormal posturing}}
{{Abnormal posturing}}
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{{CMG}} {{AE}} {{Hilda}}


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==Overview==
==Overview===
Decerebrate and decorticate posturing can indicate that [[brain herniation]] is occurring<ref name="Ayling ">{{cite journal | last =Ayling  | first = J| authorlink = | coauthors = | title =Managing head injuries | journal =Emergency Medical Services | volume =31 | issue = 8| pages =42 | publisher = | date =2002  | url = | doi = | id =PMID 12224233  | accessdate =2007-01-23 }} </ref> or is about to occur.  Brain herniation is an extremely dangerous condition in which parts of the brain are pushed past hard structures within the skull.  In herniation syndrome, which is indicative of brain herniation, decorticate posturing occurs, and, if the condition is left untreated, develops into decerebrate posturing.<ref name="Ayling "/>
Decerebrate and decorticate posturing can indicate that [[brain herniation]] is occurring<ref name="Ayling ">{{cite journal | last =Ayling  | first = J| authorlink = | coauthors = | title =Managing head injuries | journal =Emergency Medical Services | volume =31 | issue = 8| pages =42 | publisher = | date =2002  | url = | doi = | id =PMID 12224233  | accessdate =2007-01-23 }} </ref> or is about to occur.  Brain herniation is an extremely dangerous condition in which parts of the brain are pushed past hard structures within the skull.  In herniation syndrome, which is indicative of brain herniation, decorticate posturing occurs, and, if the condition is left untreated, develops into decerebrate posturing.<ref name="Ayling "/>


==Causes==
==Causes==
Posturing has also been displayed by patients with [[Creutzfeldt-Jakob disease]].<ref name="Obi ">{{cite journal | last =Obi  | first =T | authorlink = | coauthors =Takatsu M, Kitamoto T, Mizoguchi K, Nishimura Y | title =A case of Creutzfeldt-Jakob disease (CJD) started with monoparesis of the left arm | journal =Rinsho Shinkeigaku (Clinical Neurology)  | volume =36 | issue =11 | pages =1245-1248 | publisher = | date =1996  | url = | doi = | id =PMID 9046857 | accessdate =2007-01-24 }} </ref>
===Common Causes===
*[[Brain abscesses]]


Decerebrate posturing can occur with diffuse cerebral [[hypoxia]].<ref name="pmid15094576">{{cite journal |author=De Rosa G, Delogu AB, Piastra M, Chiaretti A, Bloise R, Priori SG |title=Catecholaminergic polymorphic ventricular tachycardia: successful emergency treatment with intravenous propranolol |journal=Pediatric emergency care |volume=20 |issue=3 |pages=175-7 |year=2004 |pmid=15094576 |doi=}}</ref>
*[[Brain herniation]]


[[Brain abscess]]es may also cause decorticate posturing.
*[[Cerebral hemorrhage]]


===In Children===
*[[Cerebral venous sinus thrombosis]]
In children younger than age 2, posturing is not a reliable finding because their nervous systems are not yet developed.<ref name="wrong"/>  However, [[Reye's syndrome]] and traumatic brain injury can both cause decorticate posturing in children.<ref name="wrong"/> 


For reasons that are poorly understood, but which may be related to high intracranial pressure, children with [[malaria]] frequently exhibit decorticate, decerebrate, and opisthotonic posturing.<ref name="Idro ">{{cite journal | last =Idro  | first =R | authorlink = | coauthors =Otieno G, White S, Kahindi A, Fegan G, Ogutu B, Mithwani S, Maitland K, Neville BG, Newton CR | title = Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria| journal =Malaria Journal | volume =4 | issue =57 | pages = | publisher = | date = | url =http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16336645 | doi = | id =PMID 16336645 | accessdate =2007-01-21 }} </ref>
*[[Epidural hematoma]]


*[[Hypoxia]]
*[[Malaria]]
*[[Reye's syndrome]]
*[[Traumatic brain injury]]
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"|
[[Opisthotonus]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"|
[[Satoyoshi syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|
[[Opisthotonus]],
[[Reye's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|
[[Satoyoshi syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|
[[Reye's syndrome]], [[Satoyoshi syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"|
[[Cerebral hemorrhage]], [[Cerebral venous sinus thrombosis]], [[Malaria]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|
[[Malaria]], [[Opisthotonus]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"|
[[Diastasis symphysis pubis]], [[Satoyoshi syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"|
[[Brain abscess]]es, [[Brain herniation]], [[Cerebral hemorrhage]], [[Cerebral venous sinus thrombosis]], [[Creutzfeldt-Jakob disease]], [[Decerebrate posture]], [[Decerebrate rigidity]], [[Decerebration]], [[Dystonia]], [[Epidural hematoma]], [[Focal dystonia]], [[Opisthotonus]], [[Pseudoathetosis]], [[Reye's syndrome]],
[[Traumatic brain injury]]
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"|
[[Satoyoshi syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"|
[[Opisthotonus]], [[Reye's syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"|
[[Apneustic respirations]], [[Hypoxia]]
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|
[[Satoyoshi syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"|
[[Traumatic brain injury]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
===Causes in Alphabetical Order===
*[[Apneustic respirations]]
*[[Brain abscesses]]
*[[Brain herniation]]
*[[Cerebral hemorrhage]]
*[[Cerebral venous sinus thrombosis]]
*[[Creutzfeldt-Jakob disease]]
*[[Decerebrate posture]]
*[[Decerebrate rigidity]]
*[[Decerebration]]
*[[Diastasis symphysis pubis]]
*[[Dystonia]]
*[[Epidural hematoma]]
*[[Focal dystonia]]
*[[Hypoxia]]
*[[Malaria]]
*[[Opisthotonus]]
*[[Pseudoathetosis]]
*[[Reye's syndrome]]
*[[Satoyoshi syndrome]]
*[[Traumatic brain injury]]


==References==
==References==
{{Reflist|2}}


{{Reflist|2}}
[[Category:Neurotrauma]]
[[Category:Neurotrauma]]
[[Category:Signs and symptoms]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Physical examination]]
[[Category:Physical examination]]

Latest revision as of 16:44, 29 May 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]

Overview

Decerebrate and decorticate posturing can indicate that brain herniation is occurring[1] or is about to occur. Brain herniation is an extremely dangerous condition in which parts of the brain are pushed past hard structures within the skull. In herniation syndrome, which is indicative of brain herniation, decorticate posturing occurs, and, if the condition is left untreated, develops into decerebrate posturing.[1]

Causes

Common Causes

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning

Opisthotonus

Dermatologic

Satoyoshi syndrome

Drug Side Effect

Opisthotonus, Reye's syndrome

Ear Nose Throat No underlying causes
Endocrine

Satoyoshi syndrome

Environmental No underlying causes
Gastroenterologic

Reye's syndrome, Satoyoshi syndrome

Genetic No underlying causes
Hematologic

Cerebral hemorrhage, Cerebral venous sinus thrombosis, Malaria

Iatrogenic No underlying causes
Infectious Disease

Malaria, Opisthotonus

Musculoskeletal / Ortho

Diastasis symphysis pubis, Satoyoshi syndrome

Neurologic

Brain abscesses, Brain herniation, Cerebral hemorrhage, Cerebral venous sinus thrombosis, Creutzfeldt-Jakob disease, Decerebrate posture, Decerebrate rigidity, Decerebration, Dystonia, Epidural hematoma, Focal dystonia, Opisthotonus, Pseudoathetosis, Reye's syndrome, Traumatic brain injury

Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic

Satoyoshi syndrome

Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity

Opisthotonus, Reye's syndrome

Psychiatric No underlying causes
Pulmonary

Apneustic respirations, Hypoxia

Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy

Satoyoshi syndrome

Sexual No underlying causes
Trauma

Traumatic brain injury

Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. ↑ 1.0 1.1 Ayling, J (2002). "Managing head injuries". Emergency Medical Services. 31 (8): 42. PMID 12224233. |access-date= requires |url= (help)
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