61:
328:. In decerebrate posturing, the head is arched back, the arms are extended by the sides, and the legs are extended. A hallmark of decerebrate posturing is extended elbows. The arms and legs are extended and rotated internally. The patient is rigid, with the teeth clenched. The signs can be present on only one side of the body or on both sides, and they may be present just in the arms, and they may be intermittent.
430:
is occurring or is about to occur. Brain herniation is an extremely dangerous condition in which parts of the brain are pushed past hard structures within the skull. In herniation syndrome, which is indicative of brain herniation, decorticate posturing occurs, and, if the condition is left untreated,
275:
which facilitates motor neurons in the lower spinal cord supplying flexor muscles of the lower extremities. Since the corticospinal tract is interrupted, the pontine reticulospinal and the medial and lateral vestibulospinal biased extension tracts greatly overwhelm the medullary reticulospinal biased
228:
Decorticate posturing is also called decorticate response, decorticate rigidity, flexor posturing, or, colloquially, "mummy baby". 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
362:
strokes. A patient with decorticate posturing may begin to show decerebrate posturing, or may go from one form of posturing to the other. Progression from decorticate posturing to decerebrate posturing is often indicative of uncal (transtentorial) or tonsilar
175:
causes the working set of muscles to contract. The posturing may also occur without a stimulus. Since posturing is an important indicator of the amount of damage that has occurred to the brain, it is used by medical professionals to measure the severity of a
1047:
1032:
371:
is thought to be important in decerebrate rigidity due to studies in animals showing that dorsal-root transection eliminates decerebrate rigidity symptoms. Transection releases the centres below the site from higher inhibitory controls.
313:
221:
280:
The effects on these two tracts (corticospinal and rubrospinal) by lesions above the red nucleus is what leads to the characteristic flexion posturing of the upper extremities and extensor posturing of the lower extremities.
199:
patients that display decerebrate or decorticate posturing have worse outcomes than those that do not. Changes in the condition of the patient may cause alternation between different types of posturing.
1114:
883:
De Rosa G, Delogu AB, Piastra M, Chiaretti A, Bloise R, Priori SG (2004). "Catecholaminergic polymorphic ventricular tachycardia: successful emergency treatment with intravenous propranolol".
304:, decerebrate posturing is usually indicative of more severe damage at the rubrospinal tract, and hence, the red nucleus is also involved, indicating a lesion lower in the brainstem.
1107:
195:
requiring immediate medical attention. Decerebrate and decorticate posturing are strongly associated with poor outcome in a variety of conditions. For example, near-
208:
Three types of abnormal posturing are decorticate posturing, with the arms flexed over the chest; decerebrate posturing, with the arms extended at the sides; and
1100:
1861:
854:
Obi, T; Takatsu M; Kitamoto T; Mizoguchi K; Nishimura Y (1996). "A case of
Creutzfeldt–Jakob disease (CJD) started with monoparesis of the left arm".
320:
Decerebrate posturing is also called decerebrate response, decerebrate rigidity, or extensor posturing. It describes the involuntary extension of the
784:
Berne and Levy principles of physiology/ Matthew N. Levy, Bruce M. Koeppen, Bruce A. Stanton.-4th ed. Philadelphia, PA: Elsevier Mosby, 2006.
547:
616:
769:
714:
644:
457:
In children younger than age two, posturing is not a reliable finding because their nervous systems are not yet developed. However,
101:
634:
1710:
435:
375:
In competitive contact sports, posturing (typically of the forearms) can occur with an impact to the head and is termed the
736:
921:
336:
229:
inward. A person displaying decorticate posturing in response to pain gets a score of three in the motor section of the
185:
922:"Agonal Sequences in a Filmed Suicidal Hanging: Analysis of Respiratory and Movement Responses to Asphyxia by Hanging"
331:
A person displaying decerebrate posturing in response to pain receives a score of two in the motor section of the
1610:
1605:
967:
Idro, R; Otieno G; White S; Kahindi A; Fegan G; Ogutu B; Mithwani S; Maitland K; Neville BG; Newton CR (2005).
31:
885:
573:
464:
For reasons that are poorly understood, but which may be related to high intracranial pressure, children with
576:(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series). Retrieved on September 15, 2007.
256:
in the cervical spinal cord supplying the flexor muscles of the upper extremities. The rubrospinal tract and
1705:
1501:
809:(6). Kapiolani Medical Center for Women and Children; University of Hawaii; John A. Burns School of Medicine
400:
156:
969:"Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria"
1695:
1293:
392:
137:
1758:
1717:
856:
388:
325:
261:
168:
160:
1174:
586:
Nagel, FO; Kibel SM; Beatty DW (1990). "Childhood near-drowning—factors associated with poor outcome".
1788:
1256:
415:. Posturing due to stroke usually only occurs on one side of the body and may also be referred to as
265:
257:
1820:
1722:
1645:
1092:
1051:
505:
493:
285:
272:
249:
224:
Decorticate posturing, with elbows, wrists and fingers flexed, and legs extended and rotated inward
544:
339:(for infants), due to the muscles extending because of the neuro-muscular response to the trauma.
1557:
1547:
1542:
1316:
1214:
1123:
949:
485:
416:
368:
332:
230:
181:
458:
798:
1537:
1348:
1306:
1164:
1154:
1080:
1000:
941:
902:
865:
836:
765:
710:
680:
640:
613:
595:
245:
192:
125:
71:
1673:
1552:
1511:
1199:
1141:
990:
980:
933:
894:
705:
Elovic E, Edgardo B, Cuccurullo S (2004). "Traumatic brain injury". In
Cuccurullo SJ (ed.).
672:
439:
427:
376:
364:
289:
350:(e.g. mid-collicular lesion). It is exhibited by people with lesions or compression in the
1815:
1748:
1685:
1660:
1650:
1627:
1617:
1179:
740:
620:
551:
142:
Traumatic brain injury, Stroke, Intracranial hemorrhage, Brain tumors, and
Encephalopathy.
1640:
1805:
1768:
1519:
1333:
1321:
1209:
1194:
1056:
995:
968:
898:
489:
412:
75:
1855:
1840:
1783:
1381:
1271:
1231:
1184:
1169:
937:
676:
443:
408:
297:
233:, caused by the flexion of muscles due to the neuro-muscular response to the trauma.
49:
17:
953:
1778:
1595:
1471:
1464:
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1386:
1189:
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521:
301:
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209:
45:
38:
1825:
1800:
1700:
1668:
1635:
1591:
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1326:
1261:
1236:
1219:
1075:
733:
404:
347:
284:
Decorticate posturing indicates that there may be damage to areas including the
241:
271:
The second component of decorticate posturing is the disruption of the lateral
1763:
1581:
1576:
1567:
1496:
1430:
1420:
1358:
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1041:
509:
355:
343:
321:
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and traumatic brain injury can both cause decorticate posturing in children.
1835:
1795:
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1435:
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1311:
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are also known to cause the brain to swell and cause this posturing effect.
130:
1004:
985:
945:
906:
840:
869:
684:
599:
1732:
1572:
1410:
1391:
476:
Normally people displaying decerebrate or decorticate posturing are in a
468:
frequently exhibit decorticate, decerebrate, and opisthotonic posturing.
351:
293:
196:
1024:
760:
Silverberg, Mark; Greenberg, Michael R.; Hendrickson, Robert A. (2005).
312:
220:
1810:
1481:
465:
420:
152:
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Posturing can be caused by conditions that lead to large increases in
1830:
1491:
1376:
1371:
1343:
1301:
1159:
1036:
396:
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becomes incapacitated while the opposing set is not, and an external
164:
663:
Davis, RA; Davis, RL (May 1982). "Decerebrate rigidity in humans".
574:
Decorticate posture: Decorticate rigidity, abnormal flexor response
1486:
1476:
508:
was first to describe decerebrate posturing after transecting the
219:
764:. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 53.
300:. While decorticate posturing is still an ominous sign of severe
1266:
1246:
1127:
658:
656:
477:
359:
177:
172:
1096:
54:
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of cats and monkeys, causing them to exhibit the posturing.
799:"Intracranial Hypertension and Brain Herniation Syndromes"
426:
Decerebrate and decorticate posturing can indicate that
83:
191:
The presence of abnormal posturing indicates a severe
1014:
316:
Decerebrate rigidity or abnormal extensor posturing.
1741:
1659:
1626:
1528:
1444:
1357:
1292:
1134:
1066:
1018:
434:Posturing has also been displayed by patients with
346:damage, specifically damage below the level of the
136:
124:
119:
212:, in which the head and back are arched backward.
44:"Decorticate" redirects here. For other uses, see
707:Physical Medicine and Rehabilitation Board Review
803:Radiology Cases in Pediatric Emergency Medicine
449:It has also been observed in cases of hanging.
700:
698:
696:
694:
539:
537:
236:There are two parts to decorticate posturing.
1108:
8:
920:Sauvageau, Anny; Racette, Stéphanie (2007).
831:Ayling, J (2002). "Managing head injuries".
762:Greenberg's Text-Atlas of Emergency Medicine
709:. Demos Medical Publishing. pp. 54–55.
358:. Decerebrate posturing is commonly seen in
792:
790:
755:
753:
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1115:
1101:
1093:
1015:
268:biased extension in the upper extremities.
116:
994:
984:
826:
824:
614:Medical Encyclopedia: Abnormal posturing.
102:Learn how and when to remove this message
835:. Vol. 31, no. 8. p. 42.
311:
159:of the arms and legs, indicating severe
568:
566:
564:
562:
560:
533:
728:
726:
240:The first is the disinhibition of the
639:. Lippincott Williams & Wilkins.
431:develops into decerebrate posturing.
296:. It may also indicate damage to the
7:
252:. The rubrospinal tract facilitates
1862:Symptoms and signs: Nervous system
1165:Festinating gait/Parkinsonian gait
899:10.1097/01.pec.0000117927.65522.7a
262:medial and lateral vestibulospinal
25:
27:Strange posture from brain injury
1759:Overpronation/Flexible flat feet
938:10.1111/j.1556-4029.2007.00459.x
677:10.1097/00006123-198205000-00017
342:Decerebrate posturing indicates
59:
623:Retrieved on September 3, 2007.
84:check for citation inaccuracies
258:medullary reticulospinal tract
1:
743:. Retrieved January 15, 2007.
633:Shah, Tilak (November 2008).
588:South African Medical Journal
554:. Retrieved January 15, 2007.
260:biased flexion outweighs the
1210:Myopathic gait/Waddling gait
926:Journal of Forensic Sciences
337:Pediatric Glasgow Coma Scale
266:pontine reticulospinal tract
186:Pediatric Glasgow Coma Scale
163:. It occurs when one set of
797:Yamamoto, Loren G. (1996).
619:September 11, 2007, at the
1878:
833:Emergency Medical Services
391:. Such conditions include
43:
36:
29:
1611:Lower motor neuron lesion
1606:Upper motor neuron lesion
1411:Myotonia / Pseudomyotonia
1126:relating to movement and
436:Creutzfeldt–Jakob disease
244:with facilitation of the
886:Pediatric Emergency Care
550:October 3, 2005, at the
324:in response to external
248:due to severment of the
37:Not to be confused with
32:Posture (disambiguation)
401:intracranial hemorrhage
986:10.1186/1475-2875-4-57
393:traumatic brain injury
317:
225:
138:Differential diagnosis
1718:Boutonniere deformity
734:"Decorticate Posture"
636:NMS Medicine Casebook
545:"Decorticate Posture"
389:intracranial pressure
335:(for adults) and the
315:
223:
184:(for adults) and the
18:Decorticate posturing
1789:Clasp-knife response
572:WrongDiagnosis.com,
286:cerebral hemispheres
30:For other uses, see
1821:Conversion disorder
1723:Swan neck deformity
1646:Locomotive syndrome
543:AllRefer.com. 2003
506:Charles Sherrington
494:respiratory failure
419:. Diseases such as
369:gamma motor neurons
354:and lesions in the
273:corticospinal tract
250:corticospinal tract
1558:Spastic paraplegia
1548:Spastic paraplegia
1543:Periodic paralysis
1452:Abnormal posturing
1317:Dysdiadochokinesia
1253:Asynchronous gait
1215:Trendelenburg gait
1175:Marche Ă petit pas
1124:Signs and symptoms
1067:External resources
857:Rinsho Shinkeigaku
739:2008-10-14 at the
486:cardiac arrhythmia
417:spastic hemiplegia
333:Glasgow Coma Scale
318:
231:Glasgow Coma Scale
226:
182:Glasgow Coma Scale
151:is an involuntary
149:Abnormal posturing
120:Abnormal posturing
1849:
1848:
1538:Flaccid paralysis
1359:Abnormal movement
1349:Hemimotor neglect
1307:Cerebellar ataxia
1257:Gunslinger's gait
1155:Cerebellar ataxia
1090:
1089:
864:(11): 1245–1248.
484:, with risks for
322:upper extremities
246:rubrospinal tract
193:medical emergency
146:
145:
114:Medical condition
112:
111:
104:
16:(Redirected from
1869:
1553:Spastic diplegia
1520:Tonic immobility
1512:Waxy flexibility
1456:Stooped posture
1262:Hemiparetic gait
1243:Asymmetric gait
1142:Gait abnormality
1117:
1110:
1103:
1094:
1016:
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851:
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828:
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624:
610:
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583:
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555:
541:
440:cerebral hypoxia
428:brain herniation
377:fencing response
367:. Activation of
365:brain herniation
290:internal capsule
117:
107:
100:
96:
93:
87:
63:
62:
55:
21:
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1876:
1872:
1871:
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1868:
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1866:
1852:
1851:
1850:
1845:
1816:Motion sickness
1749:Rachitic rosary
1737:
1686:Joint stiffness
1661:Range of motion
1655:
1622:
1618:Sleep paralysis
1602:General causes
1524:
1440:
1353:
1288:
1200:Vestibular gait
1180:Propulsive gait
1130:
1121:
1091:
1086:
1085:
1062:
1061:
1027:
1013:
1012:
973:Malaria Journal
966:
965:
961:
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918:
914:
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758:
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741:Wayback Machine
731:
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631:
627:
621:Wayback Machine
611:
607:
585:
584:
580:
571:
558:
552:Wayback Machine
542:
535:
530:
518:
502:
474:
459:Reye's syndrome
455:
444:brain abscesses
409:brain abscesses
385:
310:
218:
206:
188:(for infants).
115:
108:
97:
91:
88:
81:
64:
60:
53:
42:
35:
28:
23:
22:
15:
12:
11:
5:
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1854:
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1847:
1846:
1844:
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1838:
1833:
1828:
1823:
1818:
1813:
1808:
1806:Astasia-abasia
1803:
1798:
1793:
1792:
1791:
1781:
1776:
1771:
1769:Bow-leggedness
1766:
1761:
1756:
1751:
1745:
1743:
1739:
1738:
1736:
1735:
1730:
1725:
1720:
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1413:
1408:
1399:
1394:
1389:
1384:
1379:
1374:
1369:
1363:
1361:
1355:
1354:
1352:
1351:
1346:
1341:
1336:
1334:Sensory ataxia
1331:
1330:
1329:
1324:
1322:Pronator drift
1319:
1314:
1304:
1298:
1296:
1290:
1289:
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1284:
1276:
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1240:
1239:
1234:
1224:
1223:
1222:
1217:
1212:
1204:
1203:
1202:
1197:
1195:Truncal ataxia
1192:
1187:
1182:
1177:
1172:
1167:
1162:
1157:
1152:
1144:
1138:
1136:
1132:
1131:
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1120:
1119:
1112:
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1097:
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1087:
1084:
1083:
1071:
1070:
1068:
1064:
1063:
1060:
1059:
1044:
1028:
1023:
1022:
1020:
1019:Classification
1011:
1010:
959:
932:(4): 957–959.
912:
875:
846:
820:
786:
777:
770:
745:
722:
715:
690:
652:
645:
625:
605:
594:(7): 422–425.
578:
556:
532:
531:
529:
526:
525:
524:
517:
514:
501:
498:
480:and have poor
473:
470:
454:
451:
413:encephalopathy
384:
381:
309:
306:
278:
277:
276:flexion tract.
269:
217:
214:
205:
202:
144:
143:
140:
134:
133:
128:
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121:
113:
110:
109:
67:
65:
58:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1874:
1863:
1860:
1859:
1857:
1842:
1841:Dancing mania
1839:
1837:
1834:
1832:
1829:
1827:
1824:
1822:
1819:
1817:
1814:
1812:
1809:
1807:
1804:
1802:
1799:
1797:
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1790:
1787:
1786:
1785:
1784:Hyperreflexia
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1767:
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1724:
1721:
1719:
1716:
1712:
1709:
1707:
1704:
1702:
1699:
1698:
1697:
1696:Hypermobility
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1692:
1689:
1687:
1684:
1680:
1677:
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1667:
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1607:
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1601:
1597:
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1578:
1574:
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1569:
1566:
1565:
1563:
1559:
1556:
1554:
1551:
1550:
1549:
1546:
1544:
1541:
1539:
1536:
1535:
1533:
1531:
1527:
1521:
1518:
1515:
1513:
1510:
1508:
1505:
1503:
1502:Joint locking
1500:
1498:
1495:
1493:
1490:
1488:
1485:
1483:
1480:
1478:
1475:
1473:
1470:
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1457:
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1447:
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1437:
1434:
1432:
1429:
1427:
1424:
1422:
1419:
1417:
1414:
1412:
1409:
1407:
1403:
1400:
1398:
1395:
1393:
1390:
1388:
1385:
1383:
1382:Fasciculation
1380:
1378:
1375:
1373:
1370:
1368:
1365:
1364:
1362:
1360:
1356:
1350:
1347:
1345:
1342:
1340:
1337:
1335:
1332:
1328:
1325:
1323:
1320:
1318:
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1313:
1310:
1309:
1308:
1305:
1303:
1300:
1299:
1297:
1295:
1291:
1283:
1280:
1279:
1277:
1273:
1272:Antalgic gait
1270:
1268:
1265:
1263:
1260:
1258:
1255:
1254:
1252:
1248:
1245:
1244:
1242:
1238:
1235:
1233:
1232:Steppage gait
1230:
1229:
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1225:
1221:
1218:
1216:
1213:
1211:
1208:
1207:
1205:
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1198:
1196:
1193:
1191:
1188:
1186:
1185:Stomping gait
1183:
1181:
1178:
1176:
1173:
1171:
1170:Magnetic gait
1168:
1166:
1163:
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978:
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927:
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867:
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838:
834:
827:
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821:
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793:
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781:
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773:
771:0-7817-4586-1
767:
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746:
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738:
735:
729:
727:
723:
718:
716:1-888799-45-5
712:
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697:
695:
691:
686:
682:
678:
674:
671:(5): 635–42.
670:
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659:
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648:
646:9780781784689
642:
638:
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629:
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295:
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287:
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274:
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254:motor neurons
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68:This article
66:
57:
56:
51:
50:Decortication
47:
40:
33:
19:
1779:Hyporeflexia
1674:Bethlem sign
1641:Gowers' sign
1596:Quadruplegia
1472:Opisthotonus
1465:Osteoporosis
1460:Camptocormia
1451:
1402:Hyperkinesia
1387:Fibrillation
1294:Coordination
1247:Leaping gait
1190:Spastic gait
1160:Choreic gait
1150:Scissor gait
1074:
1046:
1031:
976:
972:
962:
929:
925:
915:
893:(3): 175–7.
890:
884:
878:
861:
855:
849:
832:
811:. Retrieved
806:
802:
780:
761:
732:ADAM. 2005.
706:
668:
665:Neurosurgery
664:
635:
628:
608:
591:
587:
581:
522:Lazarus sign
503:
475:
463:
456:
448:
433:
425:
405:brain tumors
386:
374:
341:
330:
319:
302:brain damage
283:
279:
235:
227:
210:opisthotonus
207:
190:
161:brain injury
148:
147:
98:
89:
74:that do not
70:may contain
69:
46:Decorticator
39:poor posture
1826:Shell shock
1801:Hypnic jerk
1701:Gorlin sign
1669:Contracture
1636:Hemiparesis
1592:Tetraplegia
1406:Hypokinesia
1327:Dyssynergia
1237:Toe walking
1220:Pigeon gait
1076:MedlinePlus
813:January 24,
510:brain stems
348:red nucleus
308:Decerebrate
242:red nucleus
216:Decorticate
1764:Knock-knee
1582:Hemiplegia
1577:Paraplegia
1568:Monoplegia
1564:Syndromes
1497:Hypertonia
1431:Echopraxia
1421:Stereotypy
1282:Lotus gait
1278:Deformity
979:(57): 57.
528:References
438:, diffuse
356:cerebellum
344:brain stem
292:, and the
92:March 2019
1836:Catatonia
1796:Shivering
1774:Back knee
1754:Flat feet
1728:Scoliosis
1691:Ankylosis
1679:Club foot
1587:Triplegia
1530:Paralysis
1516:Grimacing
1507:Catalepsy
1445:Posturing
1436:Echolalia
1426:Akathisia
1416:Hypotonia
1397:Myoclonus
1367:Athetosis
1339:Asterixis
1312:Dysmetria
1227:Foot drop
1206:Muscular
482:prognoses
472:Prognosis
180:with the
157:extension
131:Neurology
126:Specialty
72:citations
1856:Category
1733:Kyphosis
1628:Weakness
1573:Diplegia
1392:Myokymia
1005:16336645
954:32188375
946:17524058
907:15094576
841:12224233
737:Archived
617:Archived
548:Archived
516:See also
453:Children
352:midbrain
298:midbrain
294:thalamus
197:drowning
171:such as
169:stimulus
78:the text
1811:Vertigo
1482:Trismus
996:1326205
870:9046857
685:7099417
612:ADAM.
600:2218768
500:History
466:malaria
421:malaria
360:pontine
326:stimuli
165:muscles
153:flexion
82:Please
1831:Stupor
1651:Ptosis
1492:Tetany
1377:Tremor
1372:Chorea
1344:Abasia
1302:Ataxia
1081:003189
1057:781.92
1003:
993:
952:
944:
905:
868:
839:
768:
713:
683:
643:
598:
490:arrest
442:, and
397:stroke
383:Causes
288:, the
76:verify
1742:Other
1487:Cramp
1477:Spasm
1042:R29.3
950:S2CID
204:Types
1267:Limp
1146:CNS
1135:Gait
1128:gait
1052:9-CM
1001:PMID
942:PMID
903:PMID
866:PMID
837:PMID
815:2007
766:ISBN
711:ISBN
681:PMID
641:ISBN
596:PMID
504:Sir
492:and
478:coma
411:and
264:and
178:coma
173:pain
48:and
1711:HSD
1706:EDS
1048:ICD
1033:ICD
991:PMC
981:doi
934:doi
895:doi
673:doi
488:or
155:or
1858::
1594:/
1575:/
1404:/
1079::
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1037:10
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940:.
930:52
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901:.
891:20
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862:36
860:.
823:^
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789:^
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669:10
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655:^
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559:^
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446:.
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399:,
395:,
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843:.
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719:.
687:.
675::
649:.
602:.
105:)
99:(
94:)
90:(
86:.
80:.
52:.
41:.
34:.
20:)
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