Decorticate posture

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Conditions associated with decorticate posture require immediate hospital treatment.

Abnormal posturing of any sort is usually associated with reduced level of consciousness (alertness). Anyone who has an abnormal posture should be examined promptly by a health care provider.

If associated with prolonged coma (unconsciousness), these behaviors can persist for an extended period of time.

Emergency measures may begin immediately, including placement of an artificial airway (breathing tube) and assistance with breathing. The person will likely be admitted to the hospital and placed in intensive care.

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After the condition is stabilized, the medical history will be obtained from family members and a more extensive physical examination will be done. The physical exam will include a detailed assessment of the nervous system.

Medical history questions may include:

• When did this behavior start?
• Is there a pattern to the occurrences?
• Is it always the same type of posture?
• Is there any significant medical history (such as a known head injury or drug use)?
• What other symptoms came before or alone 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 chemical and minerals
• Head MRI or CT scan
• Cerebral angiography
• EEG
• ICP monitoring

The outlook depends on the cause of the posturing. Neurologic injury and brain damage may often result, leaving the person with persistent neurological deficits such as coma, inability to communicate, paralysis, or seizures.

Review Date: 04/29/2009
Reviewed By: Jacob L. Heller, MD, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington, Clinic. 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).