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KAYE H. KILBURN, MD

Arch Intern Med. 1965;116(3):409-415.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CEREBRAL dysfunction and movement disorders have been recognized in patients with chronic respiratory insufficiency.^1-3 The mental dysfunction has been described as disorientation, confusion, incoherence, somnolence, obstreperousness, combativeness, bewilderment, and carbon dioxide intoxication and narcosis. In addition, fine tremors, asterixis, myoclonic jerks, sustained myoclonus, and seizures have been found.

A flapping tremor which was elicited by maintenance of certain postures, particularly by dorsiflexing the wrists with the arms outstretched, was seen by Adams and Foley in patients with impending hepatic coma who also manifested inappropriate behavior, mental confusion, somnolence, and slow waves in the electroencephalogram.⁴ They coined "asterixis" from the Greek "asteriktos," meaning unstable, to designate the tremor. These authors also saw the flapping tremor in patients with confusion related to uremia, polycythemia and heart failure, and hypokalemia.⁵ Austen, Carmichael, and Adams ⁶ and Conn⁷ noted asterixis and mental dysfunction in patients with severe pulmonary insufficiency.

The incidence of neurologic manifestations . . . [Full Text PDF of this Article]

Author Affiliations
DURHAM, NC

From the Department of Medicine, Duke University Medical Center (Associate Professor of Medicine), and the Medical Service, Veterans Administration Hospital (Chief of Medical Service).

Footnotes
Received for publication Dec 8, 1964; accepted March 2, 1965.

Reprint requests to Department of Medicine, Duke University Medical Center, Durham 27706.

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