Asterixis in Focal Brain Lesions

Subacute sensory neuropathy.

“…Discrete lesions in mesencephalic, thalamic and parietal lobe structures may disrupt somatosensory impulse integration, attention to stimuli and facilitation of motor activity, thus producing unilateral asterixis. 8 To the best of our knowledge, the unusual synchrony of loss of muscle tone observed in this case and the association of asterixis with obstructive hydrocephalus have not been previously described. The patient reported by Tarsey et al did not show asterixis in the period preceding ventriculoperitoneal shunting for communicating hydrocephalus.5 Presumably, intraventricular pressure was normal in their case.…”

Focal asterixis caused by a small putaminal hemorrhage

“…Other authors have reported the appearance of asterixis in parallel to recovery of the associated motor deficit (8). and in a number of instances, focal asterixis was not associated with any motor deficit (9,10). It is interesting to note that for some weeks the focal asterixis was the only demonstrable neurological abnormality resulting from the intracranial hemorrhage.…”

“…Limited damage to the striopallidal complex probably impaired GABAergic inhibitory output to the thalamus and from there to the motor cortex. Some authors (9). on the other hand, interpret focal asterixis as a localized inattention failure secondary to a disturbance of sensory integration in the mesencephalon, thalamus, or parietal cortex.…”

Neurological Aspects of Dialysis Patients

“…Malfunction of a hypothetical system concerned with maintenance of tonic postural contraction of muscle has been suggested as being responsible for the interruption (3). Bilateral and unilateral asterixis have been reported in patients with lesions localised in the mesodiencephalic region of the brain and in the parietal lobe (4,5). Myoclonus is a third type of involuntary movement which develops in a late phase of uraemic encephalopathy.…”