Essay On Asterixis

Asterixis is a flapping tremor of the wrist, metacarpophalangeal and and hip joints, which also includes arrhythmic jerking movements primarily seen in the hands. When the patient has his arms extended, his wrists dorsiflexed, the patient will be unable to hold his hands back. This motor disorder is caused by abnormalities of the diencephalic motor centers and is associated with various encephalopathies and also due to malfunctioning of the metabolism. Hence we differentiate in bilateral Asterixis, caused specifically by hepatic failure. (1) And secondly in unilateral Asterixis, caused by specific lesions in brain regions. Hyperreflexia is an exaggerated and overactive deep tendon reflex to a stimuli, processed by the involuntary nervous system. This involves the upper motor neuron and is usually resulting from spinal cord injury or metabolic disease. This reaction can include: change in heart rate, excessive sweating and high blood pressure. (2)

The young patient is brought to the emergency room with acute mental status and stroke-like symptoms. Those symptoms appear when parts of the brain get cut off from the blood supply. Firstly the

Blood analysis presented acidosis and high levels of orotic acid and ammonia. Ammonia is a product of protein catabolism, converted into urea by the liver and then excreted in the urines. Ammonia is also produced in kidneys and small and large bowels. A high level of this substance in blood is very dangerous because it has direct access to the circulatory system and it is able to reach the brain and leak through the blood-brain barrier[1]. (6-martina) An excess of ammonia is toxic and causes neurological disorders and damages, leading to Encephalopathy. As listed in the case, possible symptoms are disorientation, lethargy, slurred speech, behavior change and also motor skills impairments such as asterixis and