Wentworth-Douglass Hospital
(603) 742-5252
Decrease (-) Restore Default Increase (+) font size
Physicians
myWDconnect Patient Portal
Pay Your Bill Online
Pricing Estimates
Financial Assistance
Health Library
Health Insurance Marketplace
Interpreter and Communication Services
Surgery Preparation
Medical Records
Accountable Care Organization
Advance Directives
Clinical Research & Trials
Food and Nutrition Services
Back to Health Library   Print This Page Print    Email to a Friend Email

Definition:

Abnormal posturing is different from what is commonly called "bad posture" or "slouching." Instead, it is a tendency to hold a particular body position, or to move one or more parts of the body in a particular way.

This phenomenon is an important part of evaluating a person in a coma.

Certain abnormal posturing behaviors may be a sign of specific injuries to the central nervous system.



Alternative Names:

Pathologic posturing; Evaluating a person in a coma



Considerations:

Abnormal posturing present with little or only mild stimulation is a sign of serious central nervous system damage. Subtle abnormalities or damage of the nervous system may be brought out as posturing when performing certain tasks, such as walking on the sides of the feet, on the toes, or heels.

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 -- rigid extension of the arms and legs, downward pointing of the toes, and backward arching of the head
  • Decorticate posture -- rigidity, flexion of the arms, clenched fists, and extended legs
  • Opisthotonos -- rigidity and severe arching of the back, with the head thrown backwards

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:

Call your health care provider if:

Abnormal posturing often accompanies reduced consciousness. Anyone who shows such behaviors should be examined promptly by the health care provider.

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:

All conditions of spontaneously or easily triggered abnormal posturing require hospital treatment. This kind of movement is most normally seen in patients in coma. More subtle posturing that is triggered by a doctor at a medical visit may or may not be important.

At the hospital, emergency measures for abnormal posturing must be started immediately. This includes placement of an artificial airway (breathing tube) and assistance with breathing. The person will likely be hospitalized 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:

  • When did this behavior start?
  • Is there a pattern to the occurrences?
  • Is it always the same type of posture?
  • 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:



References:

Bleck T. Levels of consciousness and attention. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 1.




Review Date: 3/26/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Find What You Need

Events
Careers
Foundation
About Us
Contact
Directions
News
Social Media Agreement
Joint Notice
Web Privacy Policy
WDH Staff Portal

Centers & Services

Cancer Center
Cardiovascular Care
Joint Replacement
Women & Children's
Physician Offices
Other Services

Conditions & Treatments

Health Library

Support Services

Support Groups
Care-Van
Dental Center
Social Work
Food & Nutrition
Integrative Wellness
Spiritual Care
Concerns & Grievances
Homecare and Hospice

For Patients

Pay Your Bill Online
Pricing Estimates
Financial Assistance
Interpreter Services
Surgery Preparation
Medical Record Request
Advance Directives
Clinical Research & Trials

For Healthcare Professionals

Work and Life
Financial Well-Being
Career and Growth

The Wentworth-Douglass Health System includes:

 

Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100