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Tremor in Pediatric Populations: Clinical Characteristics, Differential Diagnosis, and Management Challenges
Christine M Ghadery1, Carolina Gorodetsky2, Anthony E Lang1
1Department of Medicine, Edmond J. Safra Program in Parkinson's Disease, University Health Network and the Division of Neurology; University of Toronto, Toronto, Ontario, Canada.
Insights
Pediatric tremors, often overlooked, require more research. This review synthesizes current knowledge on childhood tremors, highlighting diagnostic and management challenges due to limited pediatric-specific data.
Area of Science:
- Neurology
- Pediatrics
Background:
- Tremor is a hyperkinetic movement disorder characterized by rhythmic, involuntary oscillations.
- It can manifest in neonates and children, either in isolation or with other neurological conditions.
- Pediatric tremors are underrepresented in medical literature.
Purpose of the Study:
- To offer a clinically relevant overview of pediatric tremors.
- To consolidate current literature on childhood tremor disorders.
Main Methods:
- Literature search of PubMed until February 2024.
- Included studies in English using keywords: pediatric tremor, deep brain stimulation, focused ultrasound.
- Reviewed data from 65 articles.
Main Results:
- Focused on tremor classification, causes, clinical presentation, and treatment.
- Identified specific tremor types unique to or persisting from childhood into adulthood.
- Highlighted challenges in pediatric tremor management.
Conclusions:
- Some pediatric tremors persist into adulthood, while others are exclusive to childhood.
- A significant gap exists in pediatric-specific epidemiological and clinical studies.
- Clinical decisions for pediatric tremors often rely on adult data, posing challenges for pediatricians.
Background:
Tremor is a hyperkinetic movement disorder defined as a rhythmic, involuntary, oscillatory movement of a body part. It can present as early as in the neonatal period and may be an isolated finding or part of an associated neurological or systemic disorder. Although it is commonly seen in childhood, it is not frequently described in the literature.
Objectives:
This review aims to provide a clinically useful overview of pediatric tremors based on the current literature.
Methods:
We identified relevant studies published in English by searching PubMed (until February 2024), using the following subject headings: pediatric/tremor, deep brain stimulation, and focused ultrasound.
Results:
Data from 65 articles were critically reviewed with focus on tremor classification, etiologies, clinical features, and management.
Conclusion:
Some tremor disorders in children can persist into adulthood, however, others are exclusively seen in the pediatric population. The lack of epidemiological and clinical studies in the pediatric population creates substantial challenges for pediatricians, and medical decisions are mostly guided by adult data.
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