Asterixis, or flapping tremor, is best elicited by the extension of outstretched, opened hands. It results from the acute loss of muscle tone or contraction associated with passive or active hand/wrist extension, most likely induced by pathologic coupling of the thalamus and motor cortex.

How common is Asterixis?

It is an uncommon but important sign in clinical neurology. Initially described as a “liver flap,” its utility encompasses a galaxy of neurological and nonneurological situations. Asterixis has a rich history.

What is the cause of hepatic encephalopathy?

Hepatic encephalopathy is caused when toxins that are normally cleared from the body by the liver accumulate in the blood, eventually traveling to the brain. Many of the symptoms of hepatic encephalopathy are reversible when promptly detected and treated.