A neurological sign characterized by brief, irregular lapses in muscle tone causing a flapping tremor, most commonly seen when the hands are extended. It indicates metabolic encephalopathy, particularly liver failure.
From Greek 'a-' (not) + 'sterixis' (fixed position), literally meaning 'inability to maintain position.' The term was coined by neurologists in the mid-20th century to describe this specific type of movement disorder.
Asterixis is nicknamed 'flapping tremor' because it looks like a bird trying to fly, but it's actually the opposite of a tremor - it's brief moments when muscles completely give up! This 'negative myoclonus' is so characteristic of liver failure that it's sometimes called 'liver flap,' and it can be one of the earliest signs of hepatic encephalopathy.
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