Fencing response

The Fencing Response is a peculiar posture following a concussion, often observed in contact sports athletes who have suffered a head injury. The term describes an automatic, reflex action observed in response to a traumatic event affecting the brain, such as a concussive blow. This reflex action often involves an extended arm or arms, appearing as if the individual were preparing to engage in a fencing bout, hence its name.

Pathophysiology

The fencing response is an example of an opisthotonic posturing, a type of abnormal body posture involving rigid extension and pronation of the arms with the head tilted back, often seen in severe brain injury or death. The reflex originates from the brainstem, more specifically the vestiublar nuclei, which is responsible for the body's balance and spatial orientation. It is believed that the fencing response occurs due to an imbalance in the stimulation of the vestibular system following a traumatic injury.

Clinical Significance

The fencing response is considered a clear, observable sign of a traumatic brain injury, such as a concussion, and is often used in sports medicine as an immediate indicator for a neurological examination following a blow to the head.

Spinal Cord Injuries: Although typically seen in traumatic brain injuries, the fencing response may also be observed in patients with spinal cord injuries. It signifies an intact spinal cord reflex arc.

Concussions and CTE: Observing the fencing response in athletes can help identify those who have suffered a concussion, facilitating immediate medical attention and potentially mitigating the risk of further injuries, such as Second Impact Syndrome or the development of Chronic Traumatic Encephalopathy (CTE), a neurodegenerative disease associated with repeated head injuries.

See Also

• Concussion
• Traumatic Brain Injury
• Spinal Cord Injury
• Chronic Traumatic Encephalopathy