Asterixis
| Classification according to ICD-10 | |
|---|---|
| R27.8 | Other and unspecified coordination disorders |
| ICD-10 online (WHO version 2019) | |
Under a asterixis in liver damage and flutter tremor (Engl. Flapping tremor , from gr. Ἀ- a- [privativum] + στήριξις stḗrixis , "in-stable position"), means a grobschlägiges trembling of the hands , which especially in toxic or metabolic brain damage ( encephalopathies ) occurs. This is not a tremor in the true sense of the word , but a brief loss of tone in the muscles (negative myoclonus ) followed by a reflex corrective movement. It was first described in 1949 by Adams and Foley .
causes
Flutter tremor occurs in metabolic encephalopathies, for example in hepatic encephalopathy , acute liver failure, or Wilson's disease . Kidney failure or medication can also be the cause.
Pathophysiology
Asterixis is a symptomatic movement disorder caused by brain damage. A brief, temporary inhibition of the extensors of the forearm muscles causes the hands to flex. The hand falls down and is immediately corrected again by a quick stretching movement towards its starting position. In the legs, the asterixis leads to a disturbance of standing and walking along with falls.
Appearance
The flutter tremor becomes visible when the patient is asked to extend their arms and keep their hands straight with stretched fingers. A coarse tremor becomes noticeable, which manifests itself as sudden flexions ( flexion movements ) in the wrist , which occur rhythmically or arrhythmically with a frequency of around 3–5 Hz. This is followed by a reflex corrective movement. With the arms held at their sides, it looks like the patient is flapping their wings. The movements usually occur on both sides, but can also occur asymmetrically.
literature
- RD Adams, JM Foley: The neurological changes in the more common types of severe liver disease. In: Trans American Neurology Association. 1949; 74, pp. 217-219.
