Tremor (Pediatric) Overview

Tremor is a rhythmic, involuntary back-and-forth oscillation of part of the body. Tremor in children may be caused by many disorders including familial essential tremor, focal epilepsy, or a psychogenic movement disorder. Tremor is often seen with ataxia, dystonia, or myoclonus. Physiologic tremor is the normal shaking that occurs when people attempt to exert large forces or lift heavy objects. If a child has weakness, this type of tremor may be accentuated. Ataxia may lead to tremor when the inaccurate movements are corrected and then repeatedly over corrected.

Tremor may occur...

• While at rest
• While maintaining a fixed arm position or posture (postural tremor)
• With movement or kinetic, action, or intention tremor

Tremor may occur in the hands, feet, back, neck, face, voice, or other parts of the body. The frequency of the tremor may be described by the number of cycles per second, or Hertz (Hz). Tremor may appear suddenly, or worsen gradually over months or years. Most types of tremor disappear during sleep, only to return the next day upon awakening. Tremor is often associated with other neurological disorders; therefore, it is important to look for the cause of tremor.

In familial essential tremor, the onset may occur at any age. Once started, this type of tremor often continues or becomes slowly worse with time. Some family members may notice that the tremor improves briefly after drinking alcohol. This type of tremor is usually postural, and may be particularly evident while the child attempts to eat or drink from an open cup.

	Examination