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Asterixis is atremoror movement disorder characterized by movement of hands and wrists that resemble fluttering of wings.1There is arrhythmic flection movements of the hands with outstretched implements of war and dorsiflexion of the carpus . This tremor experienced is unvoluntary and can not be controlled by the individual . The patient suffer from Asterixis is observed to “ flap ” his articulatio radiocarpea with jerky metacarpophalangeal joints , irregular movement of the hand and sidelong movements of the finger . This precondition is also known as liver flap or flapping tremor . The term Asterixis is deduce from the two Greek language ‘ a ’ which stand for ‘ not ’ and ‘ sterixis ’ which means ‘ make position ’ . Asterixis may touch bilaterally or one-sidedly ; however , bilaterally symmetric asterixis is more common . It may be see in other musculoskeletal area such as spit and foot as well .
Symptoms of Asterixis
Asterixis is a motor disorder , symptoms of which let in :
Causes of Asterixis
The most common cause of asterixis are as follows :
Pathophysiology of Asterixis
The uncontrolled jerking in asterixis is cause by abnormal use of the diencephalic motor centers of the psyche , which in good turn leads to abnormal functioning of the muscles of the arms and carpus . In case of hepatic encephalopathy , it is caused due to scathe to the brain cell perchance because the liver is unable to metabolise ammonia to urea ( abnormal ammonia metamorphosis ) . The exact chemical mechanism of this circumstance is still unknown and a large telephone number of studies are going on in view of the same .
Risk Factors for Asterixis
Risk factors for the development of asterixis include :
Diagnosis of Asterixis
diagnosing of asterixis is done by an experient medico . It usually involve obtain a detailed case account followed by clinical examen . The patient is made to extend his arms , scatter the fingers , flex his wrist and observe for any abnormal jerks or tremor . In some cases , the dither may not be apparent instantly . In such case , the examiner hyperextend the patient ’s wrist particularly in a wholesale motion to demonstrate asterixis . Another method acting involves making the patient slow down his legs while in resistless position , with knees bent and feet flat on the table . In positive cases , flapping of the legs and hip joint may be noted as the legs devolve to the sides .
Investigative studies such as lineage work , urinalysis , CT scan , MRI , EMG , cheek conduction studies etc.3may be done based on the underlying condition and to determine the extent of the underlying disease .
Treatment of Asterixis
discourse for Asterixis postulate determination of the underlying condition and intervention planning based on the same . handling module depends on the extent of damage in the liver , kidney , brain and flighty system . achiever of the discussion for Asterixis depends on the severity of the causative disease . Based on the condition , lowering the level of ammonia water , nitrogen base compounds and atomic number 29 ( in hepatic brain disease , azotemia and Wilson ’s disease ) may assist in hold tremors .
Asterixis triggered by side effects of drugs can be rescind by discontinuation of the drug . It is advised to confer a MD for considering a dose modification or prescription of an alternate drug once the causative drug has been name .
Asterixis is medical condition triggered by unnatural tremors and jerks in the extremities , preponderantly in subdivision , hands , wrists and finger . Asterixis is cause by disorders in the motor function leading to involuntary arrhythmic movement of the hand . It can affect both sides bilaterally or it can affect only one side . Treatment modality for Asterixis are planned based on the extent of the implicit in legal injury . Although , it is not a life - jeopardize condition but certainly it can be annoying and bring in discomfort to the affected role .
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