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Intention Tremor
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Common types of tremor are: Tremor at rest.Postural tremor.Flapping tremor.Senile tremor. Essential familial tremor.Hysterical tremor.
The respiratory system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Also look for the signs of carbon dioxide retention – a bounding pulse and warm hands with dilated peripheral veins. Look for a flapping tremor by asking the patient to hold their hands out – the flapping tremor is an irregular twitching movement of the hands. The patient with a high level of carbon dioxide may also be peripherally cyanosed.
Case 19: Tremor
Published in Iqbal Khan, Medical Histories for the MRCP and Final MB, 2018
The final variety of tremor to be aware of is the flapping tremor. The ‘flapping’ tremor is best demonstrated with the arms stretched out and hands extended. There is a wide variety of causes such as liver failure, hypercapnia, kidney failure, brain damage etc.
Raymond D. Adams and Joseph M. Foley: Elaborating the neurologic manifestations of hepatic encephalopathy (1949–1953)
Published in Journal of the History of the Neurosciences, 2021
In a presentation in 1953, they correctly recognized that the flapping “tremor” (i.e., asterixis) is due to pauses in electromyographic activity and not to intermittent increases in electrical activity, as had been supposed (Adams and Foley 1953a, 1953b): Electromyographic analysis of this movement abnormality has disclosed several peculiarities. … [Electromyography] shows a brief succession of two to five beats of rhythmic discharge at a frequency of eight to ten per second followed by a silent interval of 0.2 to 0.5 seconds. The silent interval corresponds to the gross lapse of posture. After the silent interval the original posture is resumed. The silent periods in the electromyogram occurred at irregular intervals, were usually simultaneous in the flexor and extensor muscles, and were not synchronous on the two sides of the body. (Adams and Foley 1953a, 204–206)
A rare case of hemodialysis-related portosystemic encephalopathy and review of the literature.
Published in Acta Clinica Belgica, 2020
Barbara Geerinckx, Rachel Hellemans, Amaryllis H. Van Craenenbroeck, Sven Francque, Liesbeth De Waele, Jeroen Kerstens, Pieter-Jan Van Gaal, Bart Bracke, Peter Michielsen, Thomas Vanwolleghem
When 6 months in hemodialysis, the patient became progressively somnolent and disorientated at the end of the first half of one of his hemodialysis sessions. This was the first time he experienced such overt encephalopathic symptoms, although he had been complaining of severe fatigue after every session ever since he started hemodialysis 6 months ago, and had mentioned that he had been feeling somewhat sleepy and confused for a few hours after the last dialysis session two days earlier. The last few days there were also some gastro-intestinal complaints including constipation and ructus. On the initial examination, hemodynamic parameters were stable without fever. Physical assessment revealed impaired consciousness and speech, disorientation, a flapping tremor of both upper limbs, global hyperreflexia and a bilateral sustained ankle clonus. Clinical examination of the heart, lungs, and abdomen was normal.