Abnormal posturing: Description, Causes, and Risk Factors:
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 CNS.
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 contract, 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 a complete or partial lack of opposition to muscle contraction in various muscle groups.
Abnormal posturing can also be caused by conditions that lead to large increases in intracranial pressure. Such conditions include traumatic brain injury, stroke, intracranial hemorrhage, brain tumors, and encephalopathy. Posturing due to stroke usually only occurs on one side of the body and may also be referred to as spastic hemiplegia. Diseases such as malaria are also known to cause the brain to swell and cause this posturing effect.
Decerebrate and decorticate posturing can indicate that brain herniation 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, develops into decerebrate posturing.
- Increased intracranial pressure.
- Reye syndrome.
- Severe head injury.
- Uncal herniation.
Abnormal posturing has also been displayed by patients with Creutzfeldt-Jakob disease, diffuse cerebral hypoxia, and brain abscesses.
Symptoms may include the following:
Twitches in the hand or foot.
- Tremors and cramps.
- Spasms in jaw muscles.
- Loss of coordination.
- Muscle pain.
- Abnormal posture.
- Anxiety, fatigue, and stress can worsen symptoms.
Diagnosis may include medical history questions documenting abnormal posturing in detail:
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:
- Head CT scan.
- Head MRI scan.
- Head x-ray.
- ICP monitoring (monitoring of the pressure inside the brain).
All abnormal posturing should be treated in a hospital. This kind of movement is most often seen in patients who are in a coma. More subtle posturing that is caused by a doctor at a medical visit may not be as serious.
At the hospital, emergency treatment for abnormal posturing must be started right away. This includes placing a breathing tube and providing breathing assistance. The person will likely be placed in the hospital intensive care unit (ICU).
Other Treatment Options May Include:
Strength Training: This doesn't mean weightlifting or bodybuilding. Strengthening the muscles in your back helps correct posture, as more often than not the muscles allow the spine to assume the abnormal position because they have not been trained to correct it. The Mayfield Clinic says, "Adequate strength of abdominal and back muscles helps stabilize the spine." The exercises for strengthening the back and abdominals can include crunches, crunches with oblique twists (at the waist) and dumbbell rows. The dumbbells should not be so heavy that you cannot do 20 rows three times--no more than 5 lb. for beginners.
- Flexibility/Stretching: These exercises can be as simple as lying down and pulling one leg at a time toward your chest or as complex as yoga and tai chi. Simple stretching exercises like a "V" sit and reach or toe touches improve the flexibility of the entire body. Gentle yoga or tai chi exercises maintain a stretch and work to increase your flexibility as you become used to the movements. For a flexibility exercise that directly impacts the back, the Mayfield Clinic recommends a standing-backward stretch where you slowly lean back until the abdominals are completely lengthened while the back muscles and spine are lightly squeezed.
- Aerobics: High-impact aerobics might not be advisable if you suffer from pain related to your abnormal spine posture. Low-impact cardio exercises for those who suffer from pain, like walking or swimming, are recommended. If you can handle the higher impact, then try jumping rope, jogging, cycling, and skating. These exercises do not directly work on spinal posture, but the more cardiovascular activity your body gets, the better your body functions. When your body functions better, that means the muscles perform their jobs better and can better support your spine to correct or begin to correct the abnormal posture.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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