Flapping Tremor: Unraveling Asterixis—A Narrative Review
Asterixis is a subtype of negative myoclonus characterized by brief, arrhythmic lapses of sustained posture due to involuntary pauses in muscle contraction. We performed a narrative review to characterize further asterixis regarding nomenclature, historical aspects, etiology, pathophysiology, classi...
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| Format: | Article |
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MDPI AG
2024-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/3/362 |
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| author | Jamir Pitton Rissardo Sara Muhammad Venkatesh Yatakarla Nilofar Murtaza Vora Paras Paras Ana Letícia Fornari Caprara |
| author_facet | Jamir Pitton Rissardo Sara Muhammad Venkatesh Yatakarla Nilofar Murtaza Vora Paras Paras Ana Letícia Fornari Caprara |
| author_sort | Jamir Pitton Rissardo |
| collection | DOAJ |
| description | Asterixis is a subtype of negative myoclonus characterized by brief, arrhythmic lapses of sustained posture due to involuntary pauses in muscle contraction. We performed a narrative review to characterize further asterixis regarding nomenclature, historical aspects, etiology, pathophysiology, classification, diagnosis, and treatment. Asterixis has been classically used as a synonym for negative myoclonus across the literature and in previous articles. However, it is important to distinguish asterixis from other subtypes of negative myoclonus, for example, epileptic negative myoclonus, because management could change. Asterixis is not specific to any pathophysiological process, but it is more commonly reported in hepatic encephalopathy, renal and respiratory failure, cerebrovascular diseases, as well as associated with drugs that could potentially lead to hyperammonemia, such as valproic acid, carbamazepine, and phenytoin. Asterixis is usually asymptomatic and not spontaneously reported by patients. This highlights the importance of actively searching for this sign in the physical exam of encephalopathic patients because it could indicate an underlying toxic or metabolic cause. Asterixis is usually reversible upon treatment of the underlying cause. |
| first_indexed | 2024-04-24T18:02:14Z |
| format | Article |
| id | doaj.art-12ecd07da2d54073a645218ac89a9c28 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-04-24T18:02:14Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-12ecd07da2d54073a645218ac89a9c282024-03-27T13:53:24ZengMDPI AGMedicina1010-660X1648-91442024-02-0160336210.3390/medicina60030362Flapping Tremor: Unraveling Asterixis—A Narrative ReviewJamir Pitton Rissardo0Sara Muhammad1Venkatesh Yatakarla2Nilofar Murtaza Vora3Paras Paras4Ana Letícia Fornari Caprara5Neurology Department, Cooper University Hospital, Camden, NJ 08103, USANeurology Department, Mayo Clinic, Rochester, MN 55905, USAMedicine Department, Terna Speciality Hospital, Navi Mumbai 400706, Maharashtra, IndiaMedicine Department, Terna Speciality Hospital, Navi Mumbai 400706, Maharashtra, IndiaMedicine Department, Government Medical College, Patiala 147001, Punjab, IndiaMedicine Department, Federal University of Santa Maria, Santa Maria 97105110, BrazilAsterixis is a subtype of negative myoclonus characterized by brief, arrhythmic lapses of sustained posture due to involuntary pauses in muscle contraction. We performed a narrative review to characterize further asterixis regarding nomenclature, historical aspects, etiology, pathophysiology, classification, diagnosis, and treatment. Asterixis has been classically used as a synonym for negative myoclonus across the literature and in previous articles. However, it is important to distinguish asterixis from other subtypes of negative myoclonus, for example, epileptic negative myoclonus, because management could change. Asterixis is not specific to any pathophysiological process, but it is more commonly reported in hepatic encephalopathy, renal and respiratory failure, cerebrovascular diseases, as well as associated with drugs that could potentially lead to hyperammonemia, such as valproic acid, carbamazepine, and phenytoin. Asterixis is usually asymptomatic and not spontaneously reported by patients. This highlights the importance of actively searching for this sign in the physical exam of encephalopathic patients because it could indicate an underlying toxic or metabolic cause. Asterixis is usually reversible upon treatment of the underlying cause.https://www.mdpi.com/1648-9144/60/3/362asterixisanisosterixismini-asterixismyoclonushyperkineticencephalopathy |
| spellingShingle | Jamir Pitton Rissardo Sara Muhammad Venkatesh Yatakarla Nilofar Murtaza Vora Paras Paras Ana Letícia Fornari Caprara Flapping Tremor: Unraveling Asterixis—A Narrative Review Medicina asterixis anisosterixis mini-asterixis myoclonus hyperkinetic encephalopathy |
| title | Flapping Tremor: Unraveling Asterixis—A Narrative Review |
| title_full | Flapping Tremor: Unraveling Asterixis—A Narrative Review |
| title_fullStr | Flapping Tremor: Unraveling Asterixis—A Narrative Review |
| title_full_unstemmed | Flapping Tremor: Unraveling Asterixis—A Narrative Review |
| title_short | Flapping Tremor: Unraveling Asterixis—A Narrative Review |
| title_sort | flapping tremor unraveling asterixis a narrative review |
| topic | asterixis anisosterixis mini-asterixis myoclonus hyperkinetic encephalopathy |
| url | https://www.mdpi.com/1648-9144/60/3/362 |
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