Decerebration syndrome

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Classification according to ICD-10
G93.8 Other specified diseases of the brain
ICD-10 online (WHO version 2019)

Decerebration syndrome ( decerebral syndrome ) describes in medicine the changes that occur after the connection of the brain stem to the overlying neocortex is interrupted .

The most common causes of decerebral damage are severe brain injuries , inflammation of the brain , poisoning and temporary oxygen deficiency . Decerebration syndromes include loss of consciousness, paralysis of the extremities, disorders of eye movements and vegetative functions. In some cases, the damage is reversible and therefore cannot be equated with brain death .

The disturbance of wakefulness can be different depending on the place of damage and the stage of the course. There may be a sopor with little reactivity to external stimuli, or a deep coma from which the patient cannot be awakened. In the most severe cases there is an apallic syndrome (from a-pallisch = "without a cerebral mantle"). The peculiarity of the apallic syndrome is that the unconscious patients have opened their eyes and react to stimuli, but without all cerebral functions. For example, the view goes into the void and does not fixate people or objects. The reflexes and functions controlled in the brain stem are retained, for example a sleep-wake rhythm, gagging and coughing stimuli.

A Dezerebrationsstarre muscle can occur when the interruption in the brain stem below the red nucleus , but above the lateral vestibular nucleus ( Deiters core ) is located. It is based on an increase in tone of the entire extensor muscles because after removal of the red nucleus its inhibiting influence on the executive of the extensor motor neurons is eliminated and then the excitement from the Deiters core predominates.

If the damage is deeper than the Deiters nucleus , there is no rigidity of the decerebration because the predominant activation of the extensor muscles is no longer active.

See also: locked-in syndrome