HomeHealth A-ZAsterixis: Causes, Symptoms, Treatment, Diagnosis, Risk Factors

Asterixis: Causes, Symptoms, Treatment, Diagnosis, Risk Factors


Several neurological problems cause motor issues in human beings. Asterixis is one such neurological disorder affecting the motor functions of particular body parts. 

This blog is a comprehensive guide to Asterixis, its causes, treatment and preventive measures available. 

What is Asterixis? 

Asterixis is a condition when a person loses control over some of their body’s motor functions. The muscles of the fingers and wrists are the frequently affected ones. When a person has Asterixis, their hands jerk erratically, and they lose control of their muscles. The hands sometimes move, similar to a bird flapping its wings. Because of this movement, Asterixis is also referred to as a flapping hand tremor. ‌ 

What causes Asterixis? 

Asterixis is also called a liver flap for its association with liver diseases. Although the link between Asterixis and liver illness has been known for decades, it’s still difficult to fully understand how or why it occurs. Some specialists believe the condition is due to dysfunctional brain areas that regulate posture and muscular movement. Why that malfunction happens is not known. Scientists suspect there might be certain triggers, which include encephalopathies.

Encephalopathies are disorders that affect brain function. 

Some types of encephalopathy which can cause Asterixis are:

  • Hepatic encephalopathy.  The liver’s primary function is to filter toxins from the body. But when the liver is impaired, it may not efficiently remove toxins. Therefore, they can build up in the blood and enter your brain, where they disrupt the function of the brain.
  • Metabolic encephalopathy. A complication of kidney and liver disease is metabolic encephalopathy. This happens when too much or too little of certain substances like ammonia, cross the blood-brain barrier, leading to neurological misfirings.
  • Drug encephalopathy. Certain medicines like barbiturates (used for sedation) and anticonvulsants (used to treat epilepsy) can affect brain responses.
  • Cardiac encephalopathy. The brain is affected when the heart does not pump enough oxygen throughout the body.

What are the symptoms of Asterixis? 

The fluttering tremor of the hands, fingers, and wrists is the most noticeable sign of Asterixis. Since this flapping is unintentional, one has no control over it. Asterixis, which most frequently manifests as hand tremors, can also affect other body portions. In addition, the underlying reasons for the tremors may cause other symptoms. ‌These other symptoms may differ depending on whether liver, renal, cardiac, or metabolic disorders influence the brain. ‌ 

When to see a doctor? 

Contact the healthcare provider immediately if someone starts exhibiting symptoms like fluttering hands, fingers or wrists. 


What are the risk factors of Asterixis? 

Being a neurological ailment, flapping hand tremors can be influenced by anything negatively affecting the brain. ‌Some of the risk factors are mentioned below. 

  1. Stroke: Stroke results from a lack of blood supply to the brain. A blood clot or damage to a blood artery can cause a stroke. Long periods of oxygen deprivation can cause irreparable damage to numerous brain parts and may cause Asterixis. 
  2. Wilson’s disease is characterized by the liver’s inability to process copper. The brain can be harmed by an excess of copper in the body. Only one in every 30,000 people develops the disorder, making it rare. Along with personality changes and muscle stiffness, the disease can result in Asterixis.
  3. Liver disease: Hepatitis and cirrhosis are severe risks for those with liver disease. In both of these diseases, the liver develops scarring. Scarring reduces the liver’s ability to remove toxins. ‌ Thus, they can build up in the blood and enter your brain, where they disrupt the function of the brain.

What tests are used to diagnose Asterixis? 

Lab testing and a physical examination are performed to identify flapping tremors in patients. The healthcare provider will instruct the patient to flex their wrists and stretch their fingers. People with Asterixis will have no control over their hands while doing so. 

Your doctor may also ask for blood tests that tries to find mineral or chemical buildup in your blood. These blood tests may help diagnose the underlying causes of Asterixis like liver disease and kidney failure. Imaging tests such as MRI or CT scans can study brain function and detect abnormalities or damage. An EEG can also be ordered to assess the brain’s electrical activity, which may help to either confirm or rule out stroke and encephalopathy.

What are the treatment options for Asterixis? 

Treatment for Asterixis is based on the underlying cause of the disease. For instance, if the flapping hand tremor is due to kidney or liver encephalopathies, the healthcare provider would advise the patient to reduce alcohol consumption or manage diabetes that may cause further damage to the kidneys. They may also prescribe laxatives to free your body of toxins. The doctor may even plan for a liver or kidney transplant if the liver or kidney encephalopathy is severe. 

If the causal agent is Wilson disease, it will be treated by prescribing medications that stop the body from absorbing copper from food. To remove copper from body tissues, the doctor may also prescribe penicillamine or other chelating medications to do so. If the reason behind Asterixis is cardiac issues, the doctor may ask to lose weight, quit smoking or prescribe blood pressure medications. 

Sometimes the cause may be a particular drug. So, the healthcare provider may switch to a different medication to lessen the symptoms. 


Asterixis is a rare condition that points its fingers to potentially severe underlying causes. Medical intervention is required at the initial appearance of symptoms. If adequate medical help is administered, most cases can improve or even get cured completely. Look out for the signs and seek medical help as early as possible.  

Frequently Asked Questions (FAQs) 

How are the liver and Asterixis connected? 

Medical issues with the liver can reduce its efficiency in filtering out toxins, and these accumulated toxins can cause damage to brain cells. Liver conditions like hepatitis and cirrhosis scar the liver, and due to this, its efficiency reduces. People with these diseases are more at risk of developing Asterixis. 

Is epilepsy a risk factor for Asterixis? 

Yes. Epilepsy involves sudden and strong electrical impulses in the brain, which can cause Asterixis. 

Can Asterixis develop as a result of an unhealthy lifestyle? 

Yes. An unhealthy lifestyle leads to damage to different organs, which can affect the brain cells and cause Asterixis. For example, excessive consumption of alcohol may result in liver or heart damage which may lead to this condition. 

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