Asterixis is a neurological disorder that causes a person to lose motor control of certain areas of the body. Muscles — often in the wrists and fingers, although it can happen in other areas of the body — can abruptly and intermittently become lax.

This loss of muscle control is also accompanied by irregular and involuntary jerking movements. For that reason, asterixis is sometimes called “flapping tremor.” Since certain liver diseases seem linked to asterixis, it’s sometimes called “liver flap” as well. The flapping is said to resemble a bird’s wings in flight.

According to research, these wrist-hand “tremors” or “flapping” motions are most likely to occur when the arms are outstretched and wrists are flexed. Asterixis on both sides of the body is far more common than unilateral (one-sided) asterixis.

There’s no one more important to trust than yourself. Sometimes we lose trust in ourselves after we make a mistake or after someone criticizes us harshly or constantly. It can feel more difficult to make decisions when you can’t trust yourself because you fear you’ll make the wrong choice. Or you might be more prone to criticizing your own decisions after you make them.

Building trust in yourself can help boost your decision-making skills and self-confidence. This can make life feel a little easier and much more enjoyable. Here are some tips to help you learn how to trust yourself:

1. Be yourself

If you fear how others will look at you or judge you, you might find it difficult to be yourself around other people. Acting like a different person than who you really are is a sign that you’re lacking self-confidence and trust in yourself. Other people will be able to sense that.

So how do you build up your trust enough to be yourself around others? When you start to feel insecure around others, remind yourself that it’s OK to be you. Start by practicing around the people you feel most comfortable with, like your friends and close family. Take note if you feel vulnerable or uncomfortable and keep spending time with these people until your insecure feelings start to disappear.

Once you can be yourself around other people, they’ll treat you with more trust. This can help you build up your trust in yourself.

2. Set reasonable goals

Often, we aim high with our goals. Instead of aiming to make $50,000 a year from our job, we aim to make $100,000. Instead of trying to complete a project in two weeks, we try to do it in one week. And setting our goals high can be a good thing, because it motivates us to work hard for what we want.

Unfortunately, setting goals that are too ambitious has a major downside. When we don’t reach our big goals, we experience failure. Failing often can reduce your self-confidence and ability to trust yourself.

Instead of setting one big goal, try setting many little goals that put you in the direction of your big goal. Doing so will make your big goal more realistic. You’ll also gain confidence and trust in yourself while accomplishing the smaller goals along the way.

3. Be kind to yourself

You’ve probably heard the term “unconditional love.” Maybe it’s been mentioned in relation to the connection a parent has with their child, or the love that exists between siblings, friends, or even romantic partners. But did you know that it’s also very important to love yourself unconditionally?

Loving yourself unconditionally means getting rid of negative thoughts about yourself and any self-criticism after you make a mistake. Start by keeping a close eye on your inner voice, and how it reacts to your actions. Is it kind or mean? Is it accepting or critical? When you can love yourself unconditionally, you can trust yourself unconditionally. And that builds confidence.

4. Build on your strengths

Everyone is better at some things and worse at others. You probably have a good idea of what things you excel at and which things you don’t do as well with. Trusting yourself means being able to attempt to do all kinds of things without judging yourself too harshly.

However, if you’re looking to build trust in yourself, it can be helpful to do more of the things that you’re good at and less of the things that you aren’t great at. If you’re not sure what you’re good at, ask those people closest to you. Spend more time doing those things and building your trust knowing you’ll excel at those things. Be accepting of your strengths, as well as your weaknesses.

5. Spend time with yourself

When you don’t trust yourself, you might feel uncomfortable spending time looking inward. You might try to keep busy all day by constantly getting involved in activities or thinking about small things outside of yourself. Break the habit of looking away from yourself by patiently looking inward.

You can look in with meditation. Try sitting with yourself in a quiet place for 5 to 15 minutes each day. Pay close attention to your breath and body. As any thoughts or self-criticisms pass by, acknowledge them and then let them go. Allowing time for this important one-on-one with yourself can build up your self-trust.

6. Be decisive

We lack trust in ourselves when we question our actions or decisions. Sometimes we might even question who we are. That can hurt.

Build trust in yourself by breaking your habit of questioning your decisions. Next time you make a choice, stick with it. Even if it turns out not to be the best choice, there’s no use beating yourself up over the decision you made.

The best you can do is to learn from your mistake. Believe that you’ll make a better choice next time, and move on. Doing so will help you learn to be more trusting of yourself and your decision-making skills.

Trusting yourself is one of the most helpful things you can do for you in your life. It can help build your confidence, allow others to trust you more, and make the process of decision making much easier. To trust yourself, all you need is to make a little effort, create self-love, and find the ability to look inward.

The condition was first recognized nearly 80 years ago, but a lot still remains unknown about it. The disorder is thought to be caused by a malfunction in the part of the brain that controls muscle movement and posture.

Why that malfunction occurs isn’t entirely known. Researchers suspect there may be certain triggers, which include encephalopathies.

Encephalopathies are disorders that affect brain function. Symptoms include:

Some types of encephalopathy that can result in asterixis are:

  • Hepatic encephalopathy. Hepatic refers to the liver. The liver’s main function is to filter toxins from the body. But when the liver is impaired for any reason, it may not remove toxins efficiently. Consequently, they can build up in the blood and enter the brain, where they disrupt brain function.
  • Metabolic encephalopathy. A complication of liver and kidney disease is metabolic encephalopathy. This occurs when too much or too little of certain vitamins or minerals, such as ammonia, cross the blood-brain barrier, causing neurological misfirings.
  • Drug encephalopathy. Certain medications, such as anticonvulsants (used to treat epilepsy) and barbiturates (used for sedation), can affect brain responses.
  • Cardiac encephalopathy. When the heart doesn’t pump enough oxygen throughout the body, the brain is affected.

Pretty much anything that affects brain function can lead to asterixis. This includes:


A stroke occurs when blood flow to a part of the brain is restricted. This can happen because of a blood clot blocking an artery or because of a narrowing of the arteries due to things like smoking or high blood pressure.

Liver disease

Liver diseases that put you at high risk of asterixis include cirrhosis or hepatitis. Both these conditions can cause scarring of the liver. This makes it less efficient at filtering out toxins.

According to research, up to 45 percent of people with cirrhosis have hepatic (liver) encephalopathy, which puts them at greater risk for asterixis.

Kidney failure

Like the liver, the kidneys also remove toxic materials from the blood. If too many of these toxins are allowed to build up, they can alter brain function and lead to asterixis.

The kidneys and their ability to do their job can be damaged by conditions like:

  • diabetes
  • high blood pressure
  • lupus
  • certain genetic disorders

Wilson’s disease

In Wilson’s disease, the liver doesn’t adequately process the mineral copper. If left untreated and allowed to build up, copper can damage the brain. This is a rare, genetic disorder.

Experts estimate about 1 in 30,000 people have Wilson’s disease. It’s present at birth but may not become apparent until adulthood. Symptoms of toxic copper levels include:

  • asterixis
  • muscle stiffness
  • personality changes

Other risk factors

Both epilepsy and heart failure are also risk factors for asterixis.

A diagnosis of asterixis is often based on both a physical exam and lab tests. Your doctor may ask you to hold your arms out, flex your wrists, and spread your fingers. After a few seconds, a person with asterixis will involuntarily “flap” the wrists downward, then back up. Your doctor may also push against the wrists to prompt the response.

Your doctor may also order blood tests that look for buildups of chemicals or minerals in the blood. Imaging tests, such as CT scans, can examine brain function and visualize areas that may be affected.

When the underlying condition causing asterixis is treated, asterixis generally improves and even goes away entirely.

Encephalopathies of the liver or kidney

Your doctor may recommend:

  • Lifestyle and dietary changes. If you’re misusing alcohol or have a kidney-damaging condition like diabetes, your doctor can talk to you about reducing your health risks.
  • Laxatives. Lactulose in particular can speed the removal of toxins from the body.
  • Antibiotics. These drugs, like rifaximin, reduce your gut bacteria. Excessive gut bacteria can cause too much of the waste product ammonia to build up in your blood and alter brain function.
  • Transplants. In severe cases of liver or kidney damage, you may need a transplant with a healthy organ.

Metabolic encephalopathy

Your doctor will likely advise dietary changes, taking drugs that will bind to the mineral to help remove it from the body, or both. It will depend on which mineral is overabundant in your bloodstream.

Drug encephalopathy

Your doctor may change the dosage of a medication or switch you to an entirely different drug.

Cardiac encephalopathy

Getting any underlying heart conditions under control is the first step. That may mean one or a combination of the following:

Your doctor may also prescribe ACE inhibitors, which widen arteries, and beta-blockers, which slow the heartbeat.

Wilson’s disease

Your doctor may prescribe drugs such as zinc acetate, which prevents the body from absorbing copper in the food you eat. They may also prescribe chelating agents like penicillamine. It can help excrete copper out of tissues.

Asterixis isn’t common, but it’s a symptom of a serious and possibly advanced underlying disorder that needs immediate medical attention.

In fact, one study reported that 56 percent of those who presented with asterixis in relation to alcoholic liver disease died, compared to 26 percent of those who didn’t have it.

If you’ve noticed any of the flapping tremors characteristic of asterixis or you have any of the above noted risk factors, speak to your doctor. In many cases, when the condition causing asterixis is successfully treated, asterixis improves or even disappears.