Everything about Asterixis totally explained
Asterixis is a
tremor of the wrist when the wrist is extended (dorsiflexion), sometimes said to resemble a bird flapping its wings. Also called "
liver flap", it can be a sign of
hepatic encephalopathy, damage to
brain cells due to the inability of the liver to metabolize
ammonia to
urea. The cause is thought to be related to abnormal ammonia
metabolism. The term derives from the
Greek a, "not" and
stērixis, "fixed position".
Usually there are brief, arrhythmic interruptions of sustained voluntary muscle contraction causing brief lapses of posture, with a frequency of 3-5 Hz. It is bilateral, but may be asymmetric. Asterixis is seen most often in drowsy or stuporous patients with metabolic
encephalopathies, especially in decompensated
cirrhosis or
acute hepatic failure. It is also seen in some patients with renal failure and
azotemia, and in
carbon dioxide toxicity. It can also be a feature of
Wilson's disease.
R.D. Adams and J.M. Foley first described asterixis in 1949 in patients with severe liver failure and encephalopathy.
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