PERSISTENT choreo-athetotic movements are not widely recognized as being associated with portal cirrhosis of the liver although such movements are a feature of many cases of Wilson's disease (hepatolenticular degeneration). The most characteristic neurological abnormality in hepatic cirrhosis is a "flapping" tremor (asterixis). Sherlock13 has described this and the occurrence of other neuropsychiatric disturbances in her monograph. The flapping tremor and organic mental state are greatly influenced by variations in the blood levels of substances arising from the impaired deamination of protein, and improve or disappear on a diet free from protein and reappear when dietary protein is increased. In their comprehensive communication on the neurological disorder associated with liver disease, Adams and Foley1 stated that they found no instance of athetosis or chorea though repeated grimacing with peculiar lapses of voluntary movements were commonly present. Glaser6 considered that the typical rigidity, tremor, postural and other