What is Asterixis?

Asterisk, also generally known as “fluttering hand tremor,” is a neurological condition during which an individual loses motor control, often within the fingers and wrists. It is a clinical symptom that describes the patient’s inability to take care of a stable posture characterised by short, irregular, involuntary jerking movements (Rasiz and Savio, 2021).

How to rate Asterixis

The commonest technique to assess asterisk is to ask the patient to carry out each arms as if to “stop the movement”, with the wrists dorsiflexed, fingers spread, and eyes closed. Observe for 30 seconds and spot any unusual shaking within the wrist. Another technique to assess the star is to put the patient in a dorsal position (supine, with knees bent outward, with feet flat) after which allow the knees to drop to the perimeters. The presence of “flutter” within the hip joint indicates asterisk (Rasiz and Savio, 2021).

Asterixis causes

Asterixis is brought on by an abnormality of the diencephalic motor centers that regulate agonist and antagonist muscle tone, posture, and muscle movement (Bickley et al., 2021). It remains to be unclear exactly how and why this happens. It may occur unilaterally or bilaterally and could have irregular frequency and severity. Bilateral asterisk is related to metabolic encephalopathy, particularly related to liver disease, and should occur in patients with cardiac and respiratory failure (hypercapnia), uremia, electrolyte abnormalities (i.e., hypoglycemia, hypokalemia, and hypomagnesemia), and drug toxicity. High levels of phenytoin, benzodiazepines, barbiturates, valproate, gabapentin, carbazemin, lithium, deftazidime, and metoclopramide within the blood can even cause asterixia (Rasiz and Savio, 2021). Unilateral asterisk is normally brought on by brain damage within the thalamus, midbrain, parietal cortex, or frontal cortex.

Asterixis treatment

Asterixis is a disease for which there is no such thing as a specific treatment. Instead, treatment focuses on treating the underlying cause, equivalent to correcting an electrolyte imbalance, hypercapnia, or drug toxicity.
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Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and history taking (thirteenth ed.). Wolters Kluwer Health: Philadelphia.
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Rasiz, Z. and Savio, J. (2021, July 31). Asterixis.
https://www.ncbi.nlm.nih.gov/books/NBK535445.