Do you frequently encounter asterixis in patients with UTI associated encephalopathy?

The most frequently taught cause of asterixis is hepatopathy and of course hepatic encephalopathy, and has other close associations (ie, uremia), I have frequently noted this exam finding in cases of UTI-associated encephalopathy; more frequently in elderly females with pyuria/UTI with normal LFTs/NH3 and w/o AKI or uremia. Is there literature to support this and/or other clinicians who have seen an association in this particular clinical setting with asterixis exam finding?

Answer from: at Academic Institution

Yes. The teaching that asterixis is only associated with hepatic encephalopathy is definitely false. The major metabolic triad that is associated with asterixis include liver failure, kidney failure (uremia), and hypercarbia. But don't forget toxic causes! Lots of medications (including AEDs) can co...

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at Shaare Zedek Medical Center
Agreed. Negative myoclonus (asterixis) due to gaba...

Answer from: at Community Practice

Keep in mind that negative myoclonus and positive myoclonus mean the same thing clinically. Do the encephalopathic workup (toxic/metabolic/infectious) for either finding.

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