Decerebrate and Decorticate Posturing

Decorticate and decerebrate posturing are both considered pathological posturing responses to usually noxious stimuli from an external or internal source. Both involve stereotypical movements of the trunk and extremities and are typically indicative of significant brain or spinal injury. The Nobel Laurette Charles Sherrington first described decerebrate posturing in 1898 after transecting the brainstems of live monkeys and cats.

Synonymous terms for decorticate posturing include abnormal flexion, decorticate rigidity, flexor posturing, or decorticate response. Synonymous terms for decerebrate posturing include abnormal extension, decerebrate rigidity, extensor posturing, or decerebrate response.

There is a criticism within the literature of the use of the terms decorticate and decerebrate posturing in clinical contexts due to their association with discrete anatomical locations that, in reality, may not be so prescriptive. Brain lesions of several anatomical regions may cause both postures, though they do usually involve some degree of brainstem injury. It is, however, accepted that decorticate typically requires an injury more rostral than decerebrate posturing. In most literature, this level is considered the red nucleus at the intercollicular level of the midbrain.