Asterixis( flapping tremor, tremor-like clapping syndrome) is a non-rhythmical twitching against the background of tonic tension of the muscles, neck, trunk and extremities.
This disorder is manifested with involuntary athetosis and is considered a sign of metabolic encephalopathy of any etiology, most often hepatic. Externally, Asterixis resembles the disorderly clapping tremor that occurs when the hand is stretched and stretched out.
This manifestation is caused by a periodic decrease in muscle tone of paroxysmal nature.
A few seconds after the full stretching of the hand, it starts to twitch sharply and quickly returns to its original position. Non-rhythmic twitching can occur with tonic tension of any other muscles( including the tongue).The flow of this condition occurs with the participation of the muscles of the upper and lower extremities, mimic and axial muscles and muscles of the tongue.
What are the symptoms of clapping tremor?
Flepping-tremor occurs against the background of such diseases:
- mid-brain lesion;
- cirrhosis;
- renal, hepatic and respiratory deficiency;
- intoxication with heavy metal salts;
- is a Wilson-Konovalov disease( a hereditary disease accompanied by the accumulation of copper in the liver, blood and brain tissues).
Tremor-like clapping syndrome is classified into two types:
- Single-sided .Occurs in the background of hemorrhagic and ischemic stroke.
- Double-sided .Appears when the mind is darkened or when intoxicated with anticonvulsants. Often, this condition is diagnosed with bilateral damage to the thalamus and subdural hematoma. A characteristic symptomatology is also observed in metabolic and hepatic encephalopathies( therefore also called hepatic tremor).
What does it look like?
The main symptoms of asterixis are manifested in the form of non-rhythmical oscillations of different parts of the body. First of all, it is the trembling of elongated arms, and the periodic twitching of the eyelids. 
The oscillation of the limbs can be small-scale and large-scale, it all depends on the amplitude of the movements.
Trembling can be present at rest and gradually decrease with arbitrary movements.
Involuntary jitter can have a different character:
- shallow jaw of the lower jaw;
- non-rhythmical small trembling of an elongated tongue;
- involuntary vibration of the whole body;
- a trembling of a head in the form of rocking upwards-bottom and from a side in a side.
A more pronounced tremor becomes after drinking alcohol or during excitement.
Diagnosis of
Various diagnostic tests are used to determine the exact diagnosis of a particular disease of the nervous system. In the process of 
diagnostics, it is very important to accurately determine the nature and localization of the lesion. In the patient's history, all of his complaints and the results of interviews with close relatives should be taken into account.
Since most neurological diseases are of a hereditary nature, in the course of diagnosis, family history data are taken into consideration first of all.
You should also pay attention not only to the signs of illness in relatives, but also to the condition that accompanies the disease( stuttering, nocturnal enuresis, epilepsy, migraine).
Medical care
The main goal of therapy is to identify and eliminate factors that caused asterixis and concomitant disease.
Thus, with the reduction of factors that cause stress, the probability of manifestation of tremor decreases. When the first symptoms( trembling of the limbs) are manifested, it is advisable to wear heavy bracelets on your hands or keep objects. Thus, it is possible to control the movements of the hands and reduce the swing range. Also, doctors recommend reducing the amount of caffeine and alcohol consumed.
Treatment for flepming tremor is not performed in adolescence. In the presence of mild disease in adult patients, also no 
is treated. If the fluctuations are very pronounced, doctors prescribe sedatives. Asterixis, the symptoms of which appear at the time of strong excitement and disappear at rest, is treated, as a rule, with the help of hypnotics.
If a patient needs to perform precise movements in connection with his work, doctors prescribe beta-calorie therapy that can reduce the amplitude of the oscillations, or completely eliminate this pathology. Since over time the body gets used to the drug, it can be used if necessary to concentrate or in a stressful state.
Alcohol can be removed from twitching, but doctors do not recommend its frequent use, as this can lead to alcoholism. To temporarily reduce the fluctuations of the limbs, you can use a little wine before eating. In case of severe illness, when a patient is disabled, doctors perform a surgical intervention, the essence of which is the effect of electric current on the 
area of the cerebellum.
If you have a tremor in one-year-old children, most often doctors prescribe medications that improve the flow of oxygen into the tissue. Long-term therapy of clapping tremor occurs when the disease appears against the background of multiple sclerosis, Parkinson's disease, drug intoxication and hyperthyroidism.
The most commonly prescribed drugs are Clonazepam, Korgard, Primidon, Xanax, etc.
Drug therapy can be combined with folk medicine in the form of tea on the basis of soothing herbs and tinctures of motherwort and valerian. With tremors of hands and feet, you can take tincture of ginseng( 20 drops three times a day).
