Decerebrate rigidity

Many people have never heard of what brain rigidity is. This is because the lesions lead to the interruption of the connection between brain tissues, thus affecting the normal movement of the brain, so the patient's IQ and motor function are greatly affected. In severe cases, deep coma, whole body convulsions and whole body rigidity may occur. In normal times, we must find the cause of the disease and choose the appropriate method to slowly regulate it.

Causes and common diseases 1. Common causes

(1) Increased intracranial pressure: Trauma, tumors, abscesses and infarction can all cause increased intracranial pressure and lead to decerebrate rigidity. Depending on the site and severity of the injury, there may be coma, abnormal pupil size and light reflex, and general manifestations of increased intracranial pressure, such as bradycardia, increased systolic blood pressure, and increased pulse pressure.

(2) Brainstem infarction: Decerebrate rigidity can be caused by brainstem infarction. Depending on the severity of the infarction, it may be accompanied by cranial nerve palsy, ataxia, sensory loss, etc. When deep coma occurs, all reflexes disappear, and there is Doll's eye sign, positive Babinski sign and muscle weakness. Decerebrate rigidity is a late sign, along with coma. Early signs include hemiplegia, cranial nerve palsy, vertigo, ataxia and vomiting.

(3) Liver disease: In the late stage of liver disease, increased intracranial pressure and ammonia poisoning lead to coma and decerebrate rigidity, accompanied by liver odor, positive Babinski sign and deep hyperreflexia.

(4) Extremely low blood sugar: can lead to coma and decerebrate rigidity, pupil dilation, slow breathing, bradycardia, muscle spasms and epilepsy, and eventually progress to muscular atrophy.

(5) Brainstem compression and hypoxia: presence or absence of anaerobic metabolism and increased intracranial pressure. It results in decerebrate rigidity with coma, positive Babinski sign, absent Doll's eye sign, hyperreflexia, fixed pupils, and apnea.

(6) Pontine hemorrhage: There is decerebrate rigidity and coma, accompanied by general paralysis, disappearance of Doll's eye sign, hyperreflexia of deep eyes, miosis, and presence of light reflex.

(7) Posterior cranial fossa hemorrhage: There may be decerebrate rigidity. In the early stages of the disease, there may be vomiting, headache, dizziness, ataxia, neck stiffness, optic disc edema and cranial nerve paralysis, which eventually progresses to coma and respiratory arrest.

2. Other causes

Lumbar puncture to release cerebrospinal fluid to reduce intracranial pressure may cause brain stem compression, decerebrate rigidity, and coma.

Check x-ray, CT, MRI, cerebral angiography, digital subtraction angiography, ECG, brain scan and ICP monitoring. Monitor vital signs and neurological status every 30 minutes, noting any signs of increased intracranial pressure (bradycardia, increased systolic blood pressure, increased pulse pressure), and any signs of neurological deterioration (changes in breathing pattern and abnormal body temperature). The brain of children under 2 years old is not fully developed. There is no decerebrate rigidity. The most common cause of decerebrate rigidity in children is head trauma, but it can also occur when increased intracranial pressure compresses the brain stem.

The differential diagnosis should be differentiated from decortication ankylosis. Decortication spasticity damages mainly at the cerebral cortex level, while decerebrate spasticity damages mainly at the midbrain level. The latter is more serious, and the two can be seen transforming into each other in clinical practice. The typical signs of decorticate rigidity are flexion of the upper limbs and extension of the lower limbs; the typical signs of decerebrate rigidity are opisthotonos and extension rigidity of all four limbs.

Treatment principles: Find the primary disease causing decerebrate rigidity and give appropriate treatment based on the cause.