Flapping tremors are seen in the following conditions except
Flapping Tremor. Asterixis is a clinical manifestation of moderate hepatic encephalopathy in which the hands flap (low-amplitude alternating flexion and extension) when the arms are held straight and the wrists are held in extension Usually there are brief, arrhythmic interruptions of sustained voluntary muscle contraction causing brief lapses of posture, with a frequency of 3-5 Hz. It is bilateral, but may be asymmetric. Unilateral asterixis may occur with structural brain disease. It can be a sign of hepatic encephalopathy, damage to brain cells presumably due to the inability of the liver to metabolize ammonia to urea. The cause is thought to be predominantly related to abnormal ammonia metabolism. Asterixis is seen most often in drowsy or stuporous patients with metabolic encephalopathies, especially in decompensated cirrhosis or acute liver failure. It is also seen in some patients with kidney failure and azotemia. It can also be a feature of Wilson's disease. Asterixis is also seen in respiratory failure due to carbon dioxide toxicity (hypercapnia). Some drugs are known to cause asterixis, paicularly phenytoin (when it is known as phenytoin flap). Other drugs implicated include benzodiazepines, barbiturates, valproate, gabapentin, lithium, ceftazidime, and metoclopramide. Ref Harrison20th edition pg 2234
Uremic encephalopathy
Parkinsonism
Hepatic encephalopathy
Carbon dioxide narcosis
C.N.S