Tremor in Pediatric Populations: Clinical Characteristics, Differential Diagnosis, and Management Challenges

Abstract

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.

Keywords: Wilson's disease; dystonic tremor; essential tremor; neonatal tremor; shuddering.