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Encyclopedia: A: Abnormal posturing

Abnormal posturing

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Definition   

Abnormal posturing is the tendency to assume a particular body position, or to move or hold one or more parts of the body in a particular way. Certain abnormal posturing behaviors can indicate specific injuries to the nervous system.

Considerations   

Abnormal posturing is a sign of serious central nervous system damage.

Normally, when a muscle contracts, the muscles on the opposite side of the joint provide some resistance to contraction. Abnormal posturing occurs when damage to the central nervous system (brain or spinal cord) results in complete or partial lack of opposition to muscle contraction in various muscle groups.

See the following types of abnormal postures:
  • Decerebrate posture
  • Decorticate posture
  • Opisthotonos
An affected person may alternate between different postures as the condition fluctuates.

Injury or inflammation of a portion of the brain, spinal cord, or nervous system is the most common cause of abnormal posturing. The particular type of posturing can reflect the type and area of nervous system involvement.

Common Causes   

  • Increased intracranial pressure
  • Injury to nerves
  • Reye's syndrome
  • Severe head injury
  • Uncal herniation, transtentorial herniation
  • Cerebral edema

Home Care   

Most conditions associated with abnormal posturing require hospital treatment.

Call your health care provider if   

Abnormal posturing often accompanies reduced consciousness. Anyone exhibiting these behaviors should be examined promptly by the health care provider.

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

What to expect at your health care provider's office   

Emergency measures may be started immediately, including placement of an artificial airway (breathing tube) and assistance with breathing. The person will likely be hospitalized and 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:
  • Time pattern
    • When did this behavior start?
    • Is there a pattern to the occurrences?
  • Quality
    • Is it always the same type of posture?
  • Other
    • 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:
  • Head X-ray
  • Head CT scan
  • Cerebral angiography
  • EEG
  • Brain scan
  • ICP monitoring (monitoring of the pressure inside the brain)
After seeing your health care provider:
You may want to add a diagnosis related to abnormal posturing to your personal medical record.

 
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