Back arching; Abnormal posturing - opisthotonos; Decerebrate posture - opisthotonos
Opisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with their head thrown backward. If a person with opisthotonos lies on their back, only the back of their head and heels touch the surface they are on.
Opisthotonos is much more common in infants and children than in adults. It is also more extreme in infants and children because of their less mature nervous systems.
Opisthotonos may occur in infants with meningitis. This is an infection of the meninges, the membranes that cover the brain and spinal cord. Viruses, malaria, and syphilis are infections associated with opisthotonos. It may also occur as a sign of reduced brain function or injury to the nervous system.
Other causes may include:
Some antipsychotic medicines can cause a side effect called acute dystonic reaction. Opisthotonos may be part of this reaction.
In rare cases, infants born to women who drink large amounts of alcohol during pregnancy may have opisthotonos due to alcohol withdrawal.
A person who develops opisthotonos will need to be cared for in a hospital.
Go to the emergency room or call 911 or the local emergency number if symptoms of opisthotonos occur. Typically, opisthotonos is a symptom of other conditions that are serious enough for a person to seek medical attention.
This condition will be evaluated in a hospital, and emergency measures may be taken.
Your health care provider will perform a physical examination and ask about symptoms to look for the cause of opisthotonos
Questions may include:
The physical examination will include a complete checkup of the nervous system.
Tests may include:
Treatment will depend on the cause. For example, if meningitis is the cause, medicines may be given.
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Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Defects in metabolism of amino acids. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 103.BACK TO TOP
Review Date: 4/29/2023
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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