Unilateral Asterixis on Neurological Examination Unilateral asterixis is almost always associated with a structural contralateral cerebral or an ipsilateral cerebellar pathology. Bilateral asterixis is metabolic/toxic in origin. In this case, this patient had a right subcortical stroke. Dr. Boby Varkey Maramattom @bobvarkey #Unilateral #Asterixis #clinical #video #neurology #physicalexam #hands