DRUG-INDUCED ASTERIXIS AMPLIFIED BY RELAT IVE HYPOGLYCEMIA

A 58-year-old man with chronic paranoid-hallucinatoric psychosis had t ransient episodes with marked paranoid delusions, auditory hallucinati ons without confusion, shakiness of both upper extremities, tachycardi a and sweating, EMG performed with surface electrodes revealed many si lent periods in postural active muscles with maximum duration of 120 m s; blood glucose was 65-75 mg/dl. At other times, blood glucose was 13 5-140 mg/dl, EMG revealed few silent periods in postural active muscle s with maximal duration of 50 ms and the patient noted some vibration in his outstretched hands only, Drug-induced asterixis (clozapine, ben peridol) amplified by relative hypoglycemia was therefore assumed, and symptoms disappeared after oral antidiabetics were reduced.