Reversible Decerebrate and Decorticate Postures in Hepatic Coma

Reversible decerebrate and decorticate postures ordinarily indicate advanced and irreversible disease of the brain, but in three patients these postures were a presenting feature of hepatic coma, and in this situation were reversible. One patient died, and at autopsy no responsible lesions in the nervous system were found. Hepatic coma should be included in the differential diagnosis of coma with decerebrate and decorticate postures, even when signs of liver disease are not initially evident.