Asterixis

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Asterixis Classification and external resources
ICD-10	R27.8
ICD-9	781.3
DiseasesDB	33950
MeSH	C10.597.350

Asterixis (Greek a, not + stērixis, fixed position) is a flapping tremor of the wrist upon extension (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 exact cause is not known, but it is thought to be related to abnormal ammonia metabolism.

Adams and Foley first described asterixis in 1949 in patients with severe liver failure and encephalopathy.^[1] In general, 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 asymmetrical. 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. Asterixis can also be a feature of Wilson's disease.

References

External links

• -932511743 at GPnotebook
• Diagram

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 . de:Asterixisfr:Astérixis