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Clinical and Electrophysiological Characterization of Essential Tremor in 18 Children and Adolescents
Julie Piarroux1, Evgenia Dimopoulou1, Guillaume Taieb2
1Department of Pediatric Neurology, Gui de Chauliac University Hospital, Montpellier, France.
Insights
Essential tremor (ET) in children often presents with upper limb tremors and impacts quality of life. Early diagnosis is crucial, as delayed identification in childhood-onset ET can worsen functional outcomes.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Essential tremor (ET) is the most common abnormal movement disorder.
- Childhood onset occurs in 5-30% of ET patients.
Purpose of the Study:
- To describe the clinical and electrophysiological characteristics of childhood-onset ET.
- To assess the impact of ET on quality of life in pediatric patients.
Main Methods:
- A multicenter, descriptive cross-sectional study.
- Included patients ≤18 years with a confirmed ET diagnosis.
- Collected demographic, clinical, electrophysiological, and quality of life data.
Main Results:
- 18 pediatric patients (9 male, 9 female) with a mean age of 13.9 years were studied.
- Upper limb tremor onset at a mean age of 6.5 years; 28% had additional body region involvement.
- All patients experienced altered quality of life, with girls and those with longer disease duration reporting worse emotional outcomes.
- Polymyography revealed mild myoclonic jerks in 7 patients.
Conclusions:
- Childhood-onset ET is associated with delayed diagnosis and significant functional impact.
- Mild myoclonic jerks may be an underrecognized feature of ET.
- Understanding these characteristics can improve management and support for affected children.
Background:
Essential tremor (ET) is considered the most frequent abnormal movement in the general population, with childhood onset in 5 to 30% of the patients.
Methods:
A multicenter, descriptive cross-sectional study enrolled patients ⩽18 years with a definite diagnosis of ET according to the International Parkinson and Movement Disorders Society criteria. Demographic data, clinical and electrophysiological characteristics of the tremor, neurological examination and impact on quality of life were collected.
Results:
9 males and 9 females were included (mean age of 13.9 years). Tremor was characterized by : upper limb onset at a mean age of 6.5 years; at enrollment, upper limbs localization, and involvement of an additional body region in 28% of the patients; kinetic tremor in all of the patients combined with postural tremor in 17 and rest tremor in 3; tremor mean frequency of 7.6 Hz, mean burst duration of 82.7 ms; identification of mild myoclonic jerks on the polymyographic recordings in 7 patients; altered quality of life with worse emotional outcomes in girls and when a disease duration >5 years was suggested.
Discussion:
Childhood-onset ET is associated with delayed diagnosis and remarkable functional impact. Electromyographic identification of additional mild myoclonus is a new finding whose significance is discussed.
Highlights:
ET onset involved upper limbs and at inclusion, 28% of the patients exhibited involvement of an additional body region.ET impacted quality of life for all patients.Girls and patients affected for >5 years reported worse emotional outcomes.Mild myoclonic jerks were identified on 7/17 polymyographic recordings.
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