Patterns of decerebration in infants and children: Defects in homeostasis and sequelae

Abstract

Sixty four infants and children showing signs of decerebrate rigidity admitted to a pediatric unit were studied. Cases of head injury, myelomeningocele, and tumors were excluded from the series. The etiological factors causing decerebration in the remainder fell into four main groups: infections, hypoxia, metabolic disease, and intracranial hemorrhage. Increased intracranial pressure was diagnosed in 87%. Defects in homeostasis occurred in 75%, respiratory abnormalities were present in 66%, cardiovascular in 33%, hypothermia in 30%, and hyponatremia in 17%. Early recognition and treatment of raised intracranial pressure and defects in homeostasis are of the utmost importance if morbidity and mortality are to be minimized. There was a 31% mortality from the acute illness: 30% of the survivors were normal at followup examination; the remainder showed varying degrees of handicap. The severity of decerebration showed no correlation with etiology or prognosis. The study shows that a wide range of disorders can lead to the clinical picture of decerebration in the young child, and that the prognosis is probably much better than in adults showing the same symptoms and signs.