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Hepatic Encephalopathy: 5 Pearls Edition Ep3

Core IM | Internal Medicine Podcast

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Asterixis

Asterixis isn't actually a tremor. It's a form of negative myoclonus. If I don't see asterixis, does that suggest a diagnosis other than hepatic encephalopathy? To answer that question, let me ask you a more basic one. Marty, how are you checking for asterixis? I feel like I'm checking the same way everyone does; I ask the patient to hold their hands up and stop traffic. Risks extended, fingers outstretched, and I watch for flapping.

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