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Table 3 Herniation syndromes and posturing

From: Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria

Herniation syndromes Posturing (n = 163) No posturing (n = 254) P Value
Uncal1 2 (1.2) 2 (0.8) 0.64
Diencephalic2 8 (4.9) 2 (0.8) 0.02
Midbrain/upper pontine3 0 (0.0) 2 (0.8) 0.52
Lower pontine4 2 (1.2) 1 (0.4) 0.56
Medullary5 19 (11.7) 12 (4.7) 0.01
  1. 1 Unilateral mydriasis and unilateral fixed pupil, unilateral ptosis, minimal or no oculocephalic eye deviation and hemiparesis
  2. 2 Cheynes-Stokes respiration, small or midpoint pupils reactive to light, full deviation of oculocephalic response, flexor response to pain and/or decorticate posturing, hypertonia and or hypereflexia with extensor planters
  3. 3 Hyperventilation, midpoint pupils fixed to light, minimal oculocephalic deviation, extensor response to pain or decerebrate posturing
  4. 4 Shallow or ataxic respiration, midpoint pupils fixed to light, no oculocephalic response, flexion of legs only, no response to pain or decorticate posturing, flaccid with extensor planters
  5. 5 Slow irregular or gasping respirations, dilated pupils fixed to light, respiratory arrest with adequate cardiac output