What is decorticate posturing?

• A. Extension of the arms and legs with the head arched backward.
• B. Flexion of the arms toward the core.
• C. No abnormal posturing.
• D. Asymmetric posture.

Answer: (B)

Decorticate posturing occurs with severe brain injury and is characterized by abnormal flexion of the upper limbs toward the trunk. The arms are drawn in with elbows flexed, wrists and fingers flexed, and the arms adducted and internally rotated. The legs are typically extended and may be internally rotated as well. This pattern shows the disruption of pathways above the red nucleus (cerebral hemispheres or internal capsule), distinguishing it from decerebrate posturing, which involves extension of the arms and legs. The description “flexion of the arms toward the core” best captures this flexor upper-limb posture, making it the correct designation.