Asterixis

Asterixis is a type of negative myoclonus. It is a Greek word that means “not a fixed position”. Most commonly it is associated with Metabolic Encephalopathy.

It was initially described as a liver flap because it was associated with hepatic encephalopathy. Not only liver failure but multiple other diseases and drugs may cause asterixis. There is a brief loss of muscle tone in agonist muscles followed by the compensatory jerk of the antagonistic muscles in asterixis. Bilateral Asterixis is most commonly associated with metabolic encephalopathy and few drugs.

Metabolic Encephalopathy – Liver failure, Azotemia, Respiratory failure, and Congestive heart failure.

Drugs – Benzodiazepines, phenytoin, and lithium.

Suggested mechanism

The abnormal function of the Diencephalic motor cortex in the brain regulates the muscles involved in maintaining the position. Brain cells damaged by toxins in metabolic encephalopathy can be the reason behind abnormal functioning.

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