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It is exhibited by people with lesions or compression in the midbrain and lesions in the cerebellum. [7] Decerebrate posturing is commonly seen in pontine strokes. A patient with decorticate posturing may begin to show decerebrate posturing, or may go from one form of posturing to the other. [1]
Decorticate posturing, with elbows, wrists and fingers flexed, and legs extended and rotated inward. Brain herniation frequently presents with abnormal posturing, [2] a characteristic positioning of the limbs indicative of severe brain damage. These patients have a lowered level of consciousness, with Glasgow Coma Scores of three to five.
In humans, true decerebrate rigidity is rare since the damage to the brain centers it might be caused by usually are lethal. However, decorticate rigidity can be caused by bleeding in the internal capsule which causes damage to upper motor neurons. The symptoms of decorticate rigidity are flexion in the upper limbs and extension in the lower limbs.
A decorticate posturing indicates a lesion (a point of damage) at or above the red nucleus, whereas a decerebrate posturing indicates a lesion at or below the red nucleus. In other words, a decorticate lesion is closer to the cortex, as opposed to a decerebrate posturing which indicates that the lesion is closer to the brainstem.
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The facial motor nucleus contains ventral and dorsal areas that have lower motor neurons that supply the upper and lower face muscles. When central facial palsy occurs, there are lesions in the corticobulbar tract between the cerebral cortex. Because of these lesions, the facial motor nucleus reduces or destroys input in the ventral division. [1]