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November 1977

Unilateral Asterixis

Arch Neurol. 1977;34(11):722-723. doi:10.1001/archneur.1977.00500230092025

To the Editor.—  Tarsy and colleagues (Arch Neurol 34:446, 1977) reported the clinical history of a patient with a complicated neurological picture, because one aspect of it included unilateral asterixis. Their patient had been institutionalized before the most recent acute illness because of a long-standing postsubarachnoid hemorrhage hydrocephalic-like disorder with decreased memory, signs of "frontal lobe release," and an abnormal EEG. After developing asterixis, he was said to have "no significant sensory deficits," though they reported he did have reduced two-point discrimination in the hand affected with asterixis. The presence of this deficit weakens the authors' argument that the unilateral asterixis described by Leavitt and Tyler1 in association with unilateral disturbances in proprioceptive input is in some way different from that seen in the patient of Tarsy and his colleagues. The latter also dismiss as unlikely the suggestion that the hemiparetic weakness their patient sustained was directly related