A case of neonatal essential tongue tremor diagnosed due to poor feeding

We encountered a case of a neonate diagnosed with essential tongue tremor due to involuntary movements of the tongue and poor oral feeding immediately after birth. Reports of pediatric-onset essential tongue tremor, particularly neonatal-onset, are extremely rare. Neonatal-onset essential tongue tremor can result in feeding difficulties and poor weight gain, potentially affecting subsequent growth and development. Given the importance of early diagnosis and medical intervention, we report our case. A boy born at 40 weeks and 5 days of gestation, weighing 3252 g, normal delivery with an Apgar Score of 8/9. He exhibited poor feeding and tongue tremor since birth. A thorough examination was performed to differentiate involuntary tongue movements. Videofluoroscopic examination of swallowing showed stagnation of contrast medium in the oral cavity, suggesting that it was due to poor tongue movement. Based on clinical findings and various exclusion diagnoses, a diagnosis of essential tongue tremor was made. Primidone, a barbiturate anticonvulsant drug, was started with a therapeutic diagnosis. Treatment resulted in marked improvement in feeding ability, and the primidone was tapered off and discontinued without any side effects after weaning was introduced. We plan to carefully follow up on growth and developmental assessment (especially language development) and continue to provide support to patients and their families.