asterixis


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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.

as·ter·ix·is

(as'ter-ik'sis),
Involuntary jerking movements, especially in the hands, best elicited by having the patient extend the upper limb, dorsiflex the wrists, and spread the fingers; results from lapses of sustained posture; seen primarily with various metabolic and toxic encephalopathies, especially hepatic encephalopathy.
Synonym(s): flapping tremor
[G. a- priv. + stērixis, fixed position]
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

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.

as·ter·ix·is

(as-tĕr-ik'sis)
Involuntary jerking movements, especially in the hands, due to arrhythmic lapses of sustained posture; seen primarily with metabolic and toxic encephalopathies, especially hepatic encephalopathy.
Synonym(s): flapping tremor.
[G. a- priv. + stērixis, fixed position]

asterixis

A recurrent flapping tremor of the arms, like the action of a bird's wings. Asterixis is characteristic of the brain disorder associated with liver failure—hepatic encephalopathy.
References in periodicals archive ?
Patients with overt HE (OHE) present varying degrees of neuropsychiatric symptoms, such as asterixis, dyspraxia, stupor, and even coma.
Movement disorders have a wide spectrum, including spasticity, chorea, tics, athetosis, myoclonus, asterixis, hemiballismus, dystonia and many more.
In patients with HE (pwHE), except for asterixis, which is actually negative myoclonus, parkinsonian-like tremor can also be seen (5,6).
She had intact mentation, no asterixis, and no stigmata of liver disease including no palmar erythema and no telangiectasias.
On neurological exam, the patient was alert and oriented to person, place, and location, with no asterixis noted.
However pathognomonic signs encountered at earlier stages were absent: shortened attention span, lethargy, dyspraxia, altered sleep rhythm, irritability, dysarthria, and asterixis. Repeated EEGs performed two and three months after onset of neuropsychiatric symptoms, respectively, showed a discrete intermittent global slow cerebral dysfunction (Figure 2).
A physical examination should evaluate patients for the presence of stigmata of cirrhosis and asterixis. Other causes of encephalopathy should be excluded (eg, electrolyte disturbances, hypoglycemia, uremia, sepsis, thyroid dysfunction).
Physical examination revealed severe anasarca and asterixis with no focal deficit.
Mental status was intact on admission; however, on the ninth day of the admission she became lethargic and developed asterixis. Initial laboratory tests are depicted in Table 1.
Review of physical symptoms is notable for nausea and examination reveals unsteady gait and asterixis. His family denies that Mr.
DDS is a clinical phenomenon of acute neurological symptoms that varies in severity, which includes symptoms of headache, nausea, disorientation, restlessness, blurred vision, and asterixis. In general, symptoms of DDS are self-limited.