Neurosurgical Classic--XXXIII
ROBERT H. WILKINS, M.D.
Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina
D ECEREBRATE r i g i d i t y a n d s i m i l a r p h e -
n o m e n a in h u m a n s a r e p e r i o d i c a l l y
e n c o u n t e r e d in c o n t e m p o r a r y n e u r o -
s u r g i c a l p r a c t i c e . 4,1~ T h e u n d e r s t a n d i n g of
t h e s e c o n d i t i o n s is l a r g e l y t h e r e s u l t of t h e ef-
f o r t s of one m a n - - C h a r l e s S. S h e r r i n g t o n . 1-4'
7.9.11-16 S h e r r i n g t o n , w h o r e c e i v e d a N o b e l
P r i z e in 193~ for his n u m e r o u s c o n t r i b u t i o n s
in n e u r o p h y s i o l o g y , 15 d e v o t e d a m a j o r
a m o u n t of his life's w o r k to t h e s t u d y of
s p i n a l reflexes a n d t h e i r c e n t r a l c o n t r o l .
D u r i n g t h e course of t h e s e e x p e r i m e n t s , h e
d i s c o v e r e d t h a t p r e p o n t i n e t r a n s e c t i o n of t h e
b r a i n s t e m in a n i m a l s r e s u l t e d in c o n t i n u o u s
s p a s m of t h e s k e l e t a l muscles, e s p e c i a l l y t h c
e x t e n s o r s . S h e r r i n g t o n ' s a n a l y s i s of t h e
m e c h a n i s m s i n v o l v e d in t h i s p h e n o m e n o n is
one of t h e m a j o r m i l e s t o n e s of m o d e r n p h y s i -
ology2'a
" T h e phenomenon of decerebrate rigidity which
is so conspicuous in a bulbospinal cat was no
doubt observed by m a n y early investigators, in-
cluding W h y t t , Rolando and Flourens, who all
stated t h a t animals m a y survive for varying
periods following removal of the forebrain. The
significance of the decerebrate posture, however,
was not apprcciated until Sherrington's well
known paper was published on the subject in
1898 . . . . F o r some 15 years prior to this Hugh-
lings Jackson had been developing the concept of
'release' of function in order to account for various
manifestations of injury to the higher parts of the
brain in man. The concept of release is implicit in
some of the writings of Charles Bell . . . . b u t
Jackson was the first to give it general application.
I n hemip]egia, Jackson argued, the withdrawal of
cortical influence and the accompanying loss of
voluntary power led to the appearance of 'posi-
tive signs' which result from overactivity of cer-
tain lower centres normally restrained b y the
cerebral cortex. Spasticity is not due, as some had
supposed, to irritation from a lesion, b u t rather to
'release' of lower centres from cortical control.
Sherrington also interpreted the manifestations
of decerebrate rigidity as 'release phenomena,'
since they persist indefinitely; they cannot, he
maintained, be a t t r i b u t e d to irritation, for direct
irritation of the cut surfaces of the brain stem does
not increase the rigidity . . . .
517
"Decerebrate rigidity has often been reported
in man, sometimes occurring in the form of tonic
fits, but more often appearing as an enduring
rigidity developing prior to death. Jackson's [51
(1870) 'eerebellar' seizures actually represent
functional decerebration near the junction be-
tween the pons and medulla. Similar functional
deeerebrafion was reported b y Cushing . . . . but
prior to the work of Magnus and de Kleijn [sl
(191~) the criteria of the decerebrate state in man
had not been fully recognized . . . . -4
D e s p i t e t h e f a c t t h a t r i g i d i t y following
c r a n i o c e r e b r a l t r a u m a in h u m a n s is fre-
q u e n t l y n o t t h e e x a c t d u p l i c a t e of decere-
b r a t e r i g i d i t y in a n i m a l s , 4 a n d c a n be c a u s e d
o c c a s i o n a l l y b y s u p r a t e n t o r i a l as well as
m i d b r a i n lesions, 6'1~ t h e p i o n e e r i n g s t u d i e s of
S h e r r i n g t o n h a v e r e m a i n e d b a s i c to t h e
u n d e r s t a n d i n g of t h e s e c o n d i t i o n s .
References
1. BRAZIER, M. A . B . The historical development of
neurophysiology. In: Handbook of physiology. A
critical, comprehensive presentation of physiological
knowledge and concepts. J. Field, Ed. Washington,
D.C.: American Physiological Society, 1959, Sect.
1, 1 : 1-58.
2. FEARING,F. Reflex action. A study in the history
of physiological psychology. Baltimore: Williams &
Wilkins Co., 1930, xiii, 850 pp. (see pp. 220-22~).
3. FULTON, J. F. Sherrington's impact on neuro-
physiology. Brit. reed. J., 1947, 2:807 810.
z~. FULTON, Z.F. Physiology of the nervous system.
New York: Oxford Univ. Press, 1949, 3rd ed., x, 667
pp. (see pp. 157-176).
5. JACKSON,J.H. A study of convulsions. Trans. St.
Andrews reed. Grad. Ass., 1870, 3: 162-204.
6. JEFFERSON,G. Bilateral rigidity in middle menin-
geal haemorrhage. Brit. reed. J., 1921, 2: 688-685.
7. LIDDELL, n. G. T. The discovery of reflexes.
Oxford: Clarendon Press, 1960, vi, 174 pp. (see pp.
98-143).
8. ~/[AGNUS, R., and DE KLEIJN, A. Die Abhiingig-
keit des Tonus der Extremiti~tenmuskeln vonder
Kopfstellung. Pfl~ig. Arch. ges. Physiol., 1912, 145:
455-548.
9. SCttMIDT, J. E. Medical discoveries. Who and
when. A dictionary listing thousands of medical and
related scientific discoveries in alphabetical order,
giving in each case the name of the discoverer, his
profession, nationality, and floruit, and the date of
the discovery. Springfield, Ill. : Charles C Thomas,
1959, ix, 555 pp. (see p. 120).
10. SCHNEIDER, R. C. CraniocerebrM trauma. In:
518 Robert H. Wilkins
Kahn, E. A., et al. Correlative neurosurgery. Spring-
field, Ill.: Charles C Thomas, 1955, xv, 413 pp. (see
pp. ~75 3~6).
11. SUERRINGTON,C.S. On reciprocal innervation of
antagonistic muscles. Third note. Proc. roy. Soc.,
1897, 60: 414-417.
1~. SHERRINGTON, C . S . Experiments in examination
of the peripheral distribution of the fibres of the
posterior roots of some spinal nerves. II. Philos.
Trans., 1898, 190B: 45-186.
13. SHERRINGTON, C. S. Dccerebrate rigidity, and
reflex coordination of movements. J. Physiol., 1898,
22: 319-33~.
14. SHERRINGTON,C.S. The integrative action of the
nervous system. New Haven: Yale Univ. Press, 1947,
~ud ed., xxiv, 433 pp.
15. STEVENSON,L.G. Nobel Prize winners in medicine
and physiology, 1901-1950. New York: H. Schuman,
Inc., 1953, ix, ~91 pp. (see pp. 154-164).
16. U. S. NATIONAL INSTITUTE OF NEUROLOGICAL DIS-
EASESANDBLINDNESS. Great names in neurology.
Bibliography of writings by Joseph Babinski,
Victor Horsley, Charles Sherrington, and Arthur
vau Gehuchten. Bethesda, Md. : U. S. Public IIealth
Service, 1957, v, 80 pp. (see pp. 39-65).
DECEREBRATE RIGIDITY, AND RE-
FLEX COORDINATION OF MOVE-
M E N T S . * BY C. S. S H E R R I N G T O N ,
M . A . , M . D . , F . R . S . ( U n i v e r s i t y College,
Liverpool). (Three Figures in Text.)
1. Decerebrate rigidity.
~. Afferent nerve-roots and decerebrate rigidity.
3. Forms of extensor rigidity allied to decerebrate
rigidity.
4. Inhibition of decerebrate rigidity by central
stimuli.
5. Inhibition of dccerebratc rigidity by peripheral
stimuli.
1. Decerebrate Rigidity.
I n a communication to tile Royal Society in
18961 I described under the name decerebrate
rigidity a condition of long-maintained muscular
contraction supervening on removal of the cere-
bral hemispheres. The condition is one possessing
considerable physiological interest, b u t I have not
succeeded in finding any description of it prior to
the above mentioned. Although continued experi-
mentation still leaves me in doubt concerning the
actual focus of origin of the rigidity, it will be use-
ful to give here a further account of the phenome-
non and of some points connected with it.
When in the monkey after ligation of the carot-
id arteries and under deep chloroformisation the
cerebral hemispheres are removed, and little
haemorrhage has occurred, the respiratory move-
* Reprinted from The Journal of Physiology, 1898, 22:
319~3~, with the kind permission of the Secretary of
the Editorial Board.
1 Proc. Roy. Soc. LX.
merits proceed, after a slight temporary check,
regularly as before, and the chloroform narcosis
can be somewhat relaxed because profound un-
consciousness has resulted from the ablation it-
self. Then ensues, often almost at once, i.e. in a
few minutes, sometimes however only after an
interval of an hour or more, a status characterised
by a peculiar rigidity of certain joints. The elbow
joints do not allow then of the usually easily made
passive flexion, the knee joints similarly are stiffly
extended. The tail is stiff and straight instead of
flexible and drooping. The neck is rigidly ex-
tended, the head retracted, and the chin thrown
upward.
I n my observations I have been accustomed to
support the animal freely above the table. I n that
way opportunity is afforded for separate inspec-
tion and investigation of the individual parts of
the t r u n k and limbs. The joints are then free to
move with little hindrance. Moreover the exist-
ence of and even the degree of paralysis of differ-
ent regions is indicated very valuably by the ex-
tent to which the attitude is determined by mere
gravitation. If in a monkey or cat transection
below or in the lower half of the bulb has been
performed, the animal, artificial respiration when
necessary being kept up, hangs from the suspension
points with deeply drooped neck, deeply drooped
tail, and its pendent limbs flaccid and slightly
flexed. The fore-limb is slightly flexed at shoulder,
at elbow and, very slightly, at wrist. The hind-
limb is slightly flexed at hip, at knee and at ankle.
On giving the hand or foot a push forward and
then releasing it the limb swings back into and
somewhat beyond the position of its equilibrium
under gravity; and it oscillates a few times back-
ward and forward before finally settling down to
its original position.
To this condition of flaccid paralysis superven-
ing upon transection in the lower half of the bulb
the condition ensuing on removal of the cerebral
hemispheres offers a great contrast. I n the latter
case the animal, on being suspended just in the
same manner as after the former operation, hangs
with its fore-limbs thrust backward, with retrac-
tion at shoulder joint, straightened elbow, and
some flexion at wrist. The hand of the monkey is
turned with its palmar face somewhat inward. The
hind-limbs are similarly kept straightened and
thrust backward; the hip is extended, the knee
very stiffly extended, and the ankle somewhat ex-
tended. The tail in spite of its own weight, and it
is quite heavy in some species of monkey, is kept
either straight and horizontal or often stiffly
curved upward. There is a little opisthotonus of
the lumbosacral vertebral region. The head is kept
lifted against gravity and the chin is tilted upward
under the retraction and backward rotation of the
skull. The differences in general attitude assumed
after transection in the lower half of the bulb and