RS 3060a: Glasgow Coma Scale: from reading Activity Score Eye Opening Spontaneous 4 To speech 3 To pain 2 No response 1 Motor Response Glasgow Scale Follows motor commands 6 Severe: < 8 Localizes 5 Moderate: 912 Withdraws 4 Mild: 1315 Abnormal flexion posture decorticate 3 Extensor response posturedecerebrate 2 No response 1 Verbal Response Oriented 5 Confused conversation 4 Inappropriate words 3 Incomprehensible sounds 2 No response 1 Primitive Reflexes: are reflexes that normally appear in infancy and disappear as a child grows and develops control over these reflexes. Primitive reflexes can reappear when neurological conditions cause dysfunction in specific locations of the central nervous system. Two primitive reflexes relevant to TBI are decorticate and decerebrate postures. See the video clip posted on OWL to view these postures. Recall the direct and indirect motor control discussed in the stroke session. Decorticate posture: is a distinctive body posture following severe damage to corticospinal tract. Recall an UMN lesion to this spinal tract causes increased tone in antigravity muscles. Thus, the legs are extended and the upper extremities are flexed. Decerebrate posture: is a distinctive body posture following severe damage to brainstem. The legs remain extended and the arms become extended as well. We will not bother with the detailed explanation of why the arms become extended. This goes into an advanced level of neuroanatomical detail of the different extrapyramidal tracts involved with the brainstem.