Asterixis associated with anatomic cerebral lesions: a study of 45 cases

J, Río; Montalbán, J; Pujadas, Francesc; Álvarez-Sabín, José; Rovira, Àlex; Codina, A

doi:10.1111/j.1600-0404.1995.tb07024.x

Cited by 25 publications

(16 citation statements)

References 14 publications

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“…The incidence of post-stroke asterixis remains unknown. Previous studies reported bilateral asterixis due to unilateral brain lesions after infarction in the anterior cerebral artery region 2,5. In our patient the asterixis started immediately after the onset of stroke at the superior cerebellar artery and resolved within 3 days.…”

Section: Discussionsupporting

confidence: 55%

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Asterixis as a Presentation of Cerebellar Ischemic Stroke

Siniscalchi¹,

Gallelli²,

Benedetto³

et al. 2013

WestJEM

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Asterixis is not yet considered a common neurological sign of cerebellum infarction, and the pathogenic mechanism for asterixis remains elusive. We report a 58-year-old male with moderate hypertension who presented to our emergency department for acute headache in both cervical and occipital regions of the left side. About 2 hours later the patient developed ipsilateral asterixis in the upper left limb; 3 days later the asterixis disappeared. Magnetic resonance imaging of the brain disclosed cerebellar infarctions at the left superior cerebellar artery. In conclusion, we observed that a transitory asterixis associated with ipsilateral headache can be an initial clinical manifestation of ipsilateral cerebellar infarctions in the superior cerebellar artery area.

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Section: Discussionsupporting

confidence: 55%

“…Asterixis may be induced by a focal structural brain lesion such as a stroke and involves the midbrain, thalamus, parietal lobe, or frontal cortex 1,2,5. The incidence of post-stroke asterixis remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Asterixis as a Presentation of Cerebellar Ischemic Stroke

Siniscalchi¹,

Gallelli²,

Benedetto³

et al. 2013

WestJEM

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“…It is noteworthy that asterixis was bilateral in patient 6. Although concomitant involvement of the contralateral frontal cortex may be possible, previous studies have also reported bilateral asterixis due to unilateral brain lesions, 15,17 which suggests that the focal unilateral ACA infarction itself produced bilateral asterixis.…”

Section: Asterixismentioning

confidence: 95%

Involuntary Movements After Anterior Cerebral Artery Territory Infarction

Kim

2001

Stroke

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Background and Purpose —Patients with anterior cerebral artery territory infarction presenting with involuntary movements have rarely been described in the literature. Case Descriptions —The author reports 9 such patients: 3 with asterixis, 5 with hemiparkinsonism (tremor, rigidity, hypokinesia), and 1 with both. Asterixis developed in the acute stage in patients with minimal arm weakness, whereas parkinsonism was usually observed after the motor dysfunction improved in patients with initially severe limb weakness. Asterixis correlated with small lesions preferentially involving the prefrontal area; parkinsonism is related to relatively large lesions involving the supplementary motor area. Conclusions —Anterior cerebral artery territory infarction should be included in the differential diagnosis of asterixis and hemiparkinsonism.

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“…It can be seen in either corical or subcortical lesions. It is often associated with metabolic or toxic encephalopathy,22 but unilateral asterixis is reported in patients with ischemic or hemorrhagic disorders, especially those involving the thalamus 23. Epileptic negative myoclonus was also reported 24.…”

Section: Electrophysiologic Investigations For the Diagnosis Of Myoclmentioning

confidence: 99%

Electrophysiologic Assessments of Involuntary Movements: Tremor and Myoclonus

Park

Kim²

2009

JMD

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Tremor is defined as a rhythmical, involuntary oscillatory movement of a body part. Although neurological examination reveals information regarding its frequency, regularity, amplitude, and activation conditions, the electrophysiological investigations help in confirming the tremor, in differentiating it from other hyperkinetic disorders like myoclonus, and may provide etiological clues. Accelerometer with surface electromyogram (EMG) can be used to document the dominant frequency of a tremor, which may be useful as certain frequencies are more characteristic of specific etiologies than others hyperkinetic disorders. It may show rhythmic bursts, duration and activation pattern (alternating or synchronous). Myoclonus is a quick, involuntary movement. Electrophysiological studies may helpful in the evaluation of myoclonus, not only for confirming the clinical diagnosis but also for understanding the underlying physiological mechanisms. Electroencephalogram (EEG)-EMG correlates can give us important information about myoclonus. Jerk-locked back-averaging and evoked potentials with recording of the long-latency, long-loop reflexes are currently available to study the pathophysiology of myoclonus.

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Asterixis associated with anatomic cerebral lesions: a study of 45 cases

Abstract: Bilateral asterixis is not always associated with toxic or metabolic disorders and it may be a sign of some structural neurologic alterations. A good correlation was found between the presence of unilateral asterixis and structural intracranial disease.

Cited by 25 publications

References 14 publications

Asterixis as a Presentation of Cerebellar Ischemic Stroke

Asterixis as a Presentation of Cerebellar Ischemic Stroke

Involuntary Movements After Anterior Cerebral Artery Territory Infarction

Electrophysiologic Assessments of Involuntary Movements: Tremor and Myoclonus

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