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Decorticate posturing is also called decorticate response, decorticate rigidity, flexor posturing, or, colloquially, "mummy baby". [5] Patients with decorticate posturing present with the arms flexed, or bent inward on the chest, the hands are clenched into fists, and the legs extended and feet turned inward.
Brainstem damage above the red nucleus level may cause decorticate rigidity. Responding to a startling or painful stimulus, the arms flex and the legs extend. The cause is the red nucleus, via the rubrospinal tract, counteracting the extensor motorneuron's excitation from the lateral vestibulospinal and reticulospinal tracts.
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.
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.
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A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, [1] but not deeper investigation such as neuroimaging.
Opisthotonus is also described as a potential CNS symptom of heat stroke along with bizarre behavior, hallucinations, decerebrate rigidity, oculogyric crisis, and cerebellar dysfunction. [citation needed] Opisthotonus is a symptom of "lavender foal syndrome", a lethal genetic disorder in horses. [4]
The rubrospinal tract originates in the magnocellular red nucleus in the midbrain, and decussates (crosses over) at the midline in the anterior tegmental decussation. [5] [3] In the pons, it is situated medially within the rostral pontine tegmentum. [4]