Diann Shaddox Foundation for Essential Tremor
Essential Tremor in Children
Essential tremor (ET) is often thought of as an adult onset condition. However, it can start in early childhood affecting about 5% of children, predominantly involving the hands and there is often a family history of tremor. There are two kinds of hand tremor which are: Kinetic tremor only (i.e. tremor present only when the hands are moving) and Postural tremor only (i.e. tremor is visible when the hands are held outstretched) with some children experiencing both. The hand tremor leads to difficulty holding drinks, eating, writing, coloring, playing a musical instrument and sports.
Very little is known about the treatment of ET in childhood but it is helpful to be open about the condition, to discuss it and to have a common sense open approach. Children will often cope better than adults until school age when often a variety of problems such as writing, school meal times and comments from peers, may cause anxiety and embarrassment.
Essential tremor (ET) may occur in children and has a prevalence of 4.6%-5.3% of the childhood population. There is often a family history of tremor. In my study of hereditary essential tremor 25% of people with ET developed tremor in their first decade and 60% in their second decade. No tremor related disability was present before the age of ten. However, 55% of young people with ET had disability and 25% reported social handicap by the age of 20 years old.
ET inevitably affects the hands in childhood but head tremor is relatively rare, being apparent in about 5% of children. The types of hand tremor present are:
The diagnosis of tremor in children is poorly understood. A variety of genetic conditions are associated with tremor in children, including spinal muscular atrophy, mitochondrial diseases, Huntington disease, and fragile X syndrome. Brain tumors, hydrocephalus, nutritional deficiencies (e.g., vitamin B12), heavy metal poisoning, prescription medications, pyruvate carboxylase deficiency, and homocystinuria can also cause tremor in children. Tremor in children is potentially serious; patients should be promptly referred to a neurologist.23 Childhood tremor should also prompt an in-depth investigation to elucidate its cause.23
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