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Shuddering attacks in children: an early clinical manifestation of essential tremor
Insights
Shuddering attacks in infants and children are often linked to essential tremor. Recognizing this benign syndrome can prevent unnecessary medical investigations and parental concern.
Area of Science:
- Neurology
- Pediatrics
- Genetics
Background:
- Essential tremor (ET) is a common neurological disorder.
- Shuddering attacks are a poorly understood condition in infants and children.
Observation:
- Six pediatric patients with shuddering attacks also exhibited signs and family history of essential tremor.
- Shuddering spells begin in infancy or early childhood, are brief, frequent, and sometimes associated with posturing.
Findings:
- A previously unrecognized association between shuddering attacks and essential tremor in children was identified.
- Shuddering attacks are benign, decreasing in frequency or resolving by age ten.
- The pathophysiology may involve essential tremor mechanisms in the developing brain.
Implications:
- Recognition of this syndrome can prevent unnecessary diagnostic procedures and reduce parental anxiety.
- Further research into the neurochemical basis of essential tremor may elucidate the nature of these attacks.
- This finding highlights the importance of considering genetic neurological disorders in pediatric patients presenting with movement abnormalities.
Abstract:
Six infants and children presenting with shuddering attacks had evidence and a family history of essential tremor. Although this association had not been recognized, the shuddering spells caused considerable concern and led to a wide range of diagnoses. The attacks start in infancy or early childhood, are brief, often associated with some posturing, and may be very frequent. They are benign and tend to become less frequent or to remit during the latter part of the first decade. The recognition of this syndrome should avoid unnecessary investigation and concern. The pathophysiology of shuddering attacks seems to represent an expression of the mechanism of essential tremor in the immature brain. The ultimate nature of these attacks will undoubtedly be clarified when a neurochemical basis for essential tremor is found.