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asterixis

   Also found in: Wikipedia 0.01 sec.
asterixis /as·ter·ix·is/ (as″ter-ik´sis) a motor disturbance marked by intermittent lapses of an assumed posture as a result of intermittency of sustained contraction of groups of muscles; called liver flap because of its occurrence in hepatic coma, but observed also in other conditions.
as·ter·ix·is (st-rkss)
n.
An abnormal tremor consisting of involuntary jerking movements, especially in the hands, frequently occurring with impending hepatic coma and other forms of metabolic encephalopathy. Also called flapping tremor.

asterixis
[as′tərik′sis]
Etymology: Gk, a, sterixis, not fixed position
a hand-flapping tremor, often accompanying metabolic disorders. The tremor is usually induced by extending the arm and dorsiflexing the wrist. Asterixis is seen frequently in hepatic encephalopathy. Also called flapping tremor, liver flap.

Flapping Tremor
Hepatology An involuntary jerking tremor of wide amplitude elicited upon dorsiflexion of the pronated wrist and spreading of extended fingers; in full-blown flapping tremors, there is abrupt flexion of the fingers at the metacarpophalangeal joint and flexion of the wrist, occurring asynchronously with each other every few seconds, due to exaggerated reflexes; bilateral flapping tremor is quasi-pathognomonic for metabolic, often alcohol-related, hepatic encephalopathy seen in end-stage—post-fibrotic—cirrhosis due to increased blood ammonia
Neonatology Coarse bilateral tremors, accompanied by limb rigidity, hyperreflexia, resistance to flexion and extension, seen in infants born to heroin-addicted mothers who undergo ‘withdrawal’ at birth

asterixis [as″ter-ik´sis]
a motor disturbance marked by intermittent lapses of an assumed posture as a result of intermittency of sustained contraction of groups of muscles; called liver flap because of its occurrence in coma associated with liver disease, but also observed in other conditions.
 To elicit asterixis (flapping tremor) the patient extends the arm, dorsiflexes the wrist, and extends the fingers. The hand is observed for rapid, nonrhythmic extensions and flexions. From Ignatavicius and Workman, 2002.

asterixis
Flapping tremor Neurology An exaggerated muscle tremor characterized by involuntary jerking of the hand in flexion and extension, classically seen in advanced liver disease and hepatic encephalopathy


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He presented in a very similar fashion to the first case; the workup was negative except for asterixis, myoclonus, and the presence of agitation.
Negative myoclonus, also known as asterixis, is characterized by a sudden involuntary relaxation, rather than contraction, of a muscle.
Breakthrough HE as defined as an increase to a Conn score equal to or more than two; or, if the baseline Conn score was zero, an increase of 1 each in Conn score and asterixis grade.
 
 
 
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