Department of Pediatrics, Ankara Kecioren Training and Research Hospital, Ankara, Turkey.
Department of Pediatric Neurology, Ankara Kecioren Training and Research Hospital, Ankara, Turkey.
Acta Neurol Belg. 2022 Apr;122(2):479-484. doi: 10.1007/s13760-021-01804-0. Epub 2021 Oct 7.
Tremor is an involuntary, rhythmic, oscillatory movement of body parts around a central point or plane which arises from contraction of antagonist muscles. Evaluation of pediatric patients with tremor can be challenging due to limited population-based studies in children. The aim of this study is to evaluate the demographic, clinical and laboratory features of childhood tremor, retrospectively.
Patients under the age of 18 years presenting with tremor (n = 111) to the Pediatric Neurology Unit of Kecioren Research and Training Hospital between January 2014 and December 2019 were included in the study. Patients with neuromuscular disease, vertebral pathology or incomplete data in hospital records were not included. Also, benign tremor causes (jitteriness, shuddering attack, etc.) seen in the neonatal and infancy period were excluded from the study as the number of patients was insufficient. Demographic data, type and duration of tremor, accompanying symptoms, chronic diseases and medications, family history, physical and neurological examination, laboratory findings, neuroimaging findings were retrospectively analyzed and recorded.
A total of 111 children (59 girls and 52 boys) were included in our study and the female to male ratio was 1.1. The mean age at tremor onset and age at admission to hospital were 13.2 ± 2.8 years (range 4-17 years), and 14.8 ± 2.0 years (range 6-17 years), respectively. The most common type of tremor was essential tremor (62.2%), followed by enhanced physiologic (18.9%). None of the patients had acute metabolic disorder. Diagnostic tests revealed the etiology in 12 patients. These were vitamin B12 deficiency in 11 patients and multiple sclerosis in one patient. Drug-induced and task-specific tremors were determined in 4 patients each. It was determined that in patients with a positive family history, tremor appeared or was noticed at a younger age.
Most of the cases with tremor can be diagnosed accurately by a detailed medical history, physical and neurological examination. Essential tremor is the most common type of tremor in children. Laboratory tests and imaging methods have limited additional yield in elucidating the etiology. Early recognition of tremor and related signs and symptoms in childhood is important for the detection and treatment of the possible underlying cause.
震颤是身体部位围绕中心点或平面的不自主、有节奏、振荡性运动，源于拮抗肌的收缩。由于儿童中基于人群的研究有限，评估患有震颤的儿科患者可能具有挑战性。本研究的目的是回顾性评估儿童震颤的人口统计学、临床和实验室特征。
2014 年 1 月至 2019 年 12 月期间，将年龄在 18 岁以下并到基齐奥伦研究和培训医院儿科神经科就诊的震颤患者（n=111）纳入研究。未纳入患有神经肌肉疾病、脊柱病理学或住院记录不完整的患者。此外，由于新生儿和婴儿期震颤的良性原因（颤抖、颤抖发作等）数量不足，将其排除在研究之外。回顾性分析和记录人口统计学数据、震颤的类型和持续时间、伴随症状、慢性疾病和药物、家族史、体格检查和神经系统检查、实验室检查、神经影像学检查结果。
共有 111 名儿童（59 名女孩和 52 名男孩）纳入本研究，女性与男性的比例为 1.1。震颤发病年龄和入院年龄的平均值分别为 13.2±2.8 岁（4-17 岁）和 14.8±2.0 岁（6-17 岁）。最常见的震颤类型是特发性震颤（62.2%），其次是生理性震颤（18.9%）。没有患者发生急性代谢紊乱。诊断性检查确定了 12 名患者的病因。其中 11 名患者为维生素 B12 缺乏，1 名患者为多发性硬化症。各有 4 名患者被诊断为药物诱导性和任务特异性震颤。研究发现，在有家族史的患者中，震颤出现或被注意到的年龄较小。
通过详细的病史、体格检查和神经系统检查，大多数震颤病例可以准确诊断。特发性震颤是儿童最常见的震颤类型。实验室检查和影像学方法在阐明病因方面的额外收益有限。早期识别儿童震颤及相关体征和症状对发现和治疗潜在病因非常重要。
