Stimuli of increasing intensity are applied to gauge the degree of unresponsiveness and any asymmetry in sensory or motor function. Motor responses may be purposeful or reflexive. Spontaneous flexion of elbows with leg extension, termed decorticate posturing, accompanies severe damage to contralateral hemisphere above midbrain. Internal rotation of the arms with extension of elbows, wrists, and legs, termed decerebrate posturing, suggests damage to midbrain or caudal diencephalon. These postural reflexes occur in profound encephalopathic states.