Abnormal posturing

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Pathologic posturing; Evaluating a person in a coma

Abnormal posturing often accompanies reduced consciousness. Anyone who shows such behaviors should be examined promptly by the health care provider.

In some conditions such as prolonged coma, these behaviors can persist for an extended period of time.

All conditions of spontaneously or easily triggered abnormal posturing require hospital treatment. This kind of movement is most normally seen in patients in coma. More subtle posturing that is triggered by a doctor at a medical visit may or may not be important.

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At the hospital, emergency measures for abnormal posturing must be started immediately. This includes placement of an artificial airway (breathing tube) and assistance with breathing. The person will likely be hospitalized in intensive care.

The medical history will be obtained from family members and a physical examination will be performed.

Medical history questions documenting abnormal posturing in detail may include:

• When did this behavior start?
• Is there a pattern to the occurrences?
• Is it always the same type of posture?
• What other symptoms preceded or accompanied the abnormal posturing?
• Is there any significant medical history (such as a known head injury)?

The physical examination will include a complete neurological assessment.

Diagnostic testing may include:

• Cerebral angiography
• EEG
• Head CT scan
• Head MRI scan
• Head x-ray
• ICP monitoring (monitoring of the pressure inside the brain)

Review Date: 03/26/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).