Decerebrate Posturing

What is decerebrate posturing?

Decerebrate posturing is a position your body may assume automatically because of damage to or disruptions in your brain. It’s sometimes called “decerebrate rigidity.” It can be a symptom of brain injuries and many different medical conditions.

Decerebrate posturing (pronounced “dee-sair-ebb-rate”) causes certain muscle groups throughout your body to automatically tense up. It can affect one side of your body or both. When decerebrate posturing affects only one side, the affected side takes on the positions described below. The unaffected side doesn’t.

A person with decerebrate posture can have the following:

• Legs extended and rigid.
• Toes pointed away from the body and turned slightly inward.
• Arms tensed, rotated toward the center of your body so palms face away from your body’s center, and held parallel against the sides of your body.
• Wrists flexed away from your body.
• Fingers curled.
• Arched or stiff back.

People who have this posturing are always unconscious and in a coma. That means they don’t wake up or respond, even with strong prompting and efforts to wake them. Decerebrate posturing is one of the indicators that healthcare providers use when assessing coma using the Glasgow Coma Scale.

What are the most common causes of decerebrate posturing?

Decerebrate posturing usually (but not always) indicates one or more lesions affecting specific parts of your brain: the lower midbrain or pons. Your brainstem links your brain to your spinal cord, and your midbrain is the upper part of your brainstem. The pons is the section of your brainstem immediately below your midbrain.

Conditions that can cause decerebrate posturing include (but aren’t limited to):

• Concussions and traumatic brain injuries (TBIs).
• Strokes.
• Brain bleeds (intracranial hemorrhage).
• Brain tumors (including cancer), especially ones that affect your brainstem.
• Infections like meningitis, encephalitis or very severe cases of malaria.
• Increased pressure inside of your skull (intracranial hypertension).
• Hydrocephalus.
• Brain damage from lack of oxygen (cerebral hypoxia).
• Reye’s syndrome.

How is decerebrate posturing treated?

Decerebrate posturing isn’t treatable directly. The only option is to treat the underlying condition that’s causing it (if possible).

Because people who have decerebrate posturing are most likely in a coma, they may also not be able to breathe on their own. Supportive care options, like mechanical ventilation or other treatments that help maintain body systems during a coma, are also likely.

Because there are so many conditions that can cause decerebrate posturing, the treatment options vary widely. A healthcare provider is the best person to tell you about possible treatments.

What are the possible complications or risks of not treating decerebrate posturing?

Decerebrate posturing means that there’s severe damage to your brain or something is causing major disruptions in brain activity. They can cause permanent damage, which can cause a person to lose abilities that their damaged brain areas once controlled. In the most severe cases, the conditions that can cause decerebrate posturing are deadly without treatment.

Can decerebrate posturing be prevented?

Many conditions that cause decerebrate posturing are preventable, or you may be able to reduce your chances of developing them. Some things you can do include:

• Manage your chronic conditions. Follow your healthcare provider’s guidance on managing chronic conditions like diabetes, high blood pressure and epilepsy.
• Wear safety equipment as needed. Head injuries, especially concussions and traumatic brain injuries, are among the most common causes of decerebrate posturing. Protect your brain from injury using safety equipment, like helmets and seat belts.
• Eat a balanced diet. Electrolyte imbalances and nutrient deficiencies are often avoidable (or you can reduce the risk of having them). Managing what you eat can also help avoid decerebrate posturing related to many brain-related conditions, especially strokes.
• Stay physically active and reach and maintain a weight that’s healthy for you. Your weight and how active you are can prevent or delay conditions that affect your brain. Healthcare providers can guide you on reaching and maintaining a weight that’s healthy for you.
• Avoid substance and nonmedical drug use, and use alcohol in moderation. Substance use disorders can be an underlying cause of decerebrate posturing. Always take prescription medications exactly as directed and avoid nonmedical drug and substance use.
• Seek treatment for infections. Many infections that affect your brain start close by in places like your eyes, nose or ears. Don’t delay treatment for infections in these areas. Prompt treatment can help you avoid the spread of infections that can lead to conditions like decerebrate posturing.

When should decerebrate posturing be treated by a doctor or healthcare provider?

A person with uncontrolled muscle movements of any kind when unconscious and unresponsive (meaning they don’t wake up when you try to rouse them) needs immediate medical care. Call 911 (or your local emergency services number) right away.

Is recovery from a condition that causes decerebrate posturing possible?

Recovery from a condition that causes decerebrate posturing may be possible, depending on the underlying cause. Recovery is most likely to happen when the cause is a condition or event that’s reversible or treatable.

However, even with treatment, decerebrate posturing tends to have an unfavorable outlook. Unfortunately, most people who have it don’t survive.

A note from Cleveland Clinic

It can be scary to see someone you know or care about experiencing a symptom like decerebrate posturing. This symptom often happens when someone is in a coma because of a severe illness or injury affecting their brain.

But advances in modern medicine mean there are more ways to diagnose and treat the conditions that can cause it. Researchers continue to find new ways to help treat the conditions that cause decerebrate posturing, offering hope to those who have a loved one affected by them.