Severe asterixis due to hypermagnesemia in chronic renal failure: a case report

Morimatsu, Mitsunori; Ono, Kaoru; Harada, Akira

doi:10.1007/s10072-020-04945-x

Cited by 4 publications

(2 citation statements)

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“…Asterixis was already associated with decreased [ 119 ] and increased [ 120 ] magnesium serum levels. Decreased levels of magnesium are commonly observed in individuals with alcoholic hepatitis, so the cases presenting hypomagnesemia associated with asterixis may be only anecdotal [ 119 ].…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Decreased levels of magnesium are commonly observed in individuals with alcoholic hepatitis, so the cases presenting hypomagnesemia associated with asterixis may be only anecdotal [ 119 ]. Morimatsu et al described a case of chronic magnesium laxative use presenting with asterixis, in which the severe asterixis of the whole body gradually decreased in severity along with the decreasing magnesium concentration [ 120 ]. Also, hypermagnesemia, when associated with hypocalcemia, may induce choreiform movements and seizures [ 121 ].…”

Section: Differential Diagnosismentioning

confidence: 99%

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Flapping Tremor: Unraveling Asterixis—A Narrative Review

Rissardo,

Muhammad,

Yatakarla

et al. 2024

Medicina

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Asterixis is a subtype of negative myoclonus characterized by brief, arrhythmic lapses of sustained posture due to involuntary pauses in muscle contraction. We performed a narrative review to characterize further asterixis regarding nomenclature, historical aspects, etiology, pathophysiology, classification, diagnosis, and treatment. Asterixis has been classically used as a synonym for negative myoclonus across the literature and in previous articles. However, it is important to distinguish asterixis from other subtypes of negative myoclonus, for example, epileptic negative myoclonus, because management could change. Asterixis is not specific to any pathophysiological process, but it is more commonly reported in hepatic encephalopathy, renal and respiratory failure, cerebrovascular diseases, as well as associated with drugs that could potentially lead to hyperammonemia, such as valproic acid, carbamazepine, and phenytoin. Asterixis is usually asymptomatic and not spontaneously reported by patients. This highlights the importance of actively searching for this sign in the physical exam of encephalopathic patients because it could indicate an underlying toxic or metabolic cause. Asterixis is usually reversible upon treatment of the underlying cause.

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Section: Differential Diagnosismentioning

confidence: 99%