Forensic Sci Med Pathol (2013) 9:249250
DOI 10.1007/s12024-012-9403-5
COMMENTARY
Cadaveric spasm
Burkhard Madea
Accepted: 15 December 2012 / Published online: 4 January 2013
 Springer Science+Business Media New York 2012
With irreversible circulatory arrest and/or respiratory arrest
striated muscle loses tone and becomes flaccid [1]. Bate-
Smith and Bendall [24] divided changes in the elasticity
of mammalian muscles undergoing rigor mortis into three
phases:
a delay period with high elasticity of muscle,
a rapid phase with decreasing elasticity, and
a post rigor phase with constant elasticity at a lower
level.
Bate-Smith and Bendall also studied the factors deter-
mining the time course of rigor mortis [3]. Even in animals
with antemortem energy exhaustion (e.g. after strychnine
injection) a short delay period was observed. The experi-
ments of Bate-Smith and Bendall are, of course, of great
heuristic value for forensic practice since they deal with
factors governing the time course of rigor mortis (ambient
temperature, pre-existing diseases, violent exercise prior to
death [energy depletion], poisoning, and electrocution) on
a biochemical and physical level [1, 5].
The delay period until the onset or complete develop-
ment of rigor mortis may be used for estimating the time
since death by examining the electrical excitability of
skeletal muscles [6, 7]. In forensic practice many condi-
tions have been described which may accelerate or delay
the onset of rigor mortis. For instance, an accelerated onset
of rigor mortis can be seen in cases of electrocution when
the body has remained in direct or indirect contact with
electrical current until the cadaver is discovered [5].
B. Madea (&)
Institute of Forensic Medicine, University of Bonn, Stiftsplatz
12, 53111 Bonn, Germany
e-mail: b.madea@uni-bonn.de
The term cadaveric spasm is defined either as
accelerated rigor mortis or as instantaneous rigor
mortis. According to Bernard Knight, cadaveric spasm
may well be an extreme variant of accelerated rigor mortis.
It is a rare form of virtually instantaneous rigor that
develops at the time of death without a period of post
mortem flaccidity [8]. However, according to Knight,
cadaveric spasm has received a disproportional amount of
notice in major textbooks compared to its practical
importance. Many forensic pathologists claim to have
observed such a phenomenon far too soon after death for
this to be normal rigor mortis [8]. Although authors are
skeptic about this phenomenon, Knight has described one
or two cases genuine enough to be remarkably early for
usual rigor. The phenomenon usually affects only one
group of muscles such as the flexors of one arm, rather than
the whole body. Cadaveric spasm seems to be confined to
those deaths that occur in the midst of intense physical
and/or emotional activity [8]. According to Knight it must
be initiated by motor nerve activity but for some reason
there is a failure of normal relaxation. To diagnose
cadaveric spasm the body must be examined before
ordinary rigor mortis might be expected to have developed.
Otherwise, the presence of cadaveric spasm cannot be
assumed. According to Krompecher, instantaneous rigor
mortis or cadaveric spasm are also defined as complete
rigor mortis occurring at the moment of death and
involving a hand, limb, or even the entire body (cataleptic
rigor) [5]. According to Baumann who carried out a survey
on cataleptic rigor in 1923, two possibilities in establishing
the diagnosis have to be differentiated [9]: either the person
is observed while dying and instantaneous rigor is noted at
the moment of death or the observation is made some time
after death with body parts erected against gravity. In both
cases, the whole body or parts of it have remained in the
123
250
Fig. 1 Death of Marat by Jacques Louis David, Royal Museum of
Art, Brussels
same position as they were prior to death and the position
has not been changed by gravity. Baumann surveyed the
literature on this subject and concluded that the majority of
cases of instantaneous rigor mortis are seen in individuals
with brain injuries. Even as early as 1923 he stated that
many reports on cadaveric spasm are misdiagnoses because
the development of rigor mortis had not been observed. Up
to now there is no pathophysiological concept to explain
cadaveric spasm. Laves [10] and Prokop [11] proposed that
the cause of cadaveric spasm or cadaveric rigidity may be
decerebration rigidity according to Sherrington. However,
decerebration rigidity is a vital phenomenon and many
reports on cataleptic rigidity originate from incidents dur-
ing wars (e.g. Franco-Prussian 1870/71 and World War I
1914/18). Unusual positions were more likely to have
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Forensic Sci Med Pathol (2013) 9:249250
resulted from blast waves. Mueller, a famous German
forensic pathologist, who also worked during World War
II, searched for cases of cataleptic rigidity but failed to
observe a single case of instantaneous rigor mortis [5].
Altogether, there is no pathophysiological basis for
instantaneous rigor mortis or cadaveric spasm. Therefore,
as recommended by Bedford and Tsokos, the term cadav-
eric spasm should not be used any longer [12]. Most cases
are misreported because the development of rigor mortis
has not been observed. The presence of objects in a hand is
not an extraordinary finding and does not prove instanta-
neous development of rigor mortis. For example, in the
famous painting Death of Marat by Jacques Louis
David, the paper in the left hand and the quill in the right
hand of the dead Marat is simply consistent with the effects
of gravity (Fig. 1).
References
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