Reversible Decerebrate Posture in Hepatic Encephalopathy: Case Report and Literature Review

Decerebrate posturing is commonly associated with a global brain insult as in massive strokes, brain stem infarction, or hypoxic brain injury. The clinical presentation of hepatic encephalopathy is variable. ranging from an abnormal sleep pattern to somnolence and deep coma. Decerebrate or decorticate posturing is a rare manifestation of hepatic encephalopathy. We report a patient with liver cirrhosis who presented with a mild degree of hepatic encephalopathy that rapidly progressed to coma with decerebrate posturing. Although the pathophysiology of hepatic encephalopathy is unknown, it appears to be reversible as in our patient who completely recovered with the management of encephalopathy. Despite being uncommon, it should be considered in patients presenting with hepatic encephalopathy progressing to coma since it might save unnecessary workup.