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Tremors/shaking in my son's hands...Need Advice please!

Posted by on Apr. 4, 2009 at 2:33 PM
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My son is 2 1/2 and  is in the early intervention program because he is slightly delayed with his speech. His speech therapist brought up the point that if he is trying to do something really miticulous or having to work at something really hard that his hands will shake...I told her that I thought that he just wanted to do it perfect and thats why I thought he was shaking....anyways she kept on about it and I called his pediatrician and spoke with her and she said no I don't think that is anything that we should worry about at this time as long as he's not doing it all the time and its not interferring with his everyday life...then my son had his 6 month developmental evaluation and that therapist brought up the "tremors/shaking" to me, but she agreed with me....Well I told the speech lady what the dev. lady had said and she said NO I DON'T BELIEVE THAT AT ALL!! and was kind of hateful and everytime she comes she just goes on and on about it...So I spoke with his ped. again and she said that same thing....that she has seen a lot of children that are just "working to hard" and their hands will have small tremors, she said she's even send children to the neurologist before over it and they say theres nothing wrong with them................anyways....does anyone elses child/children do this???? Any advice would be appreciated!!  Thanks!

toddler boyKyle James 07-19-2006 5 pounds 12.4 ounces 19 1/2 inches long




toddler girlAva Lyn 02-06-08 8 pounds 1.2 ounces 20 1/2 inches long




 




 




 




 




 




 




 




 

by on Apr. 4, 2009 at 2:33 PM
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Kristin2008
by on Apr. 4, 2009 at 8:57 PM

Anyone?

toddler boyKyle James 07-19-2006 5 pounds 12.4 ounces 19 1/2 inches long




toddler girlAva Lyn 02-06-08 8 pounds 1.2 ounces 20 1/2 inches long




 




 




 




 




 




 




 




 

Annette4
by Bronze Member on Apr. 6, 2009 at 12:59 PM

Hi Kristen!

Wow, what a battle of wills amongst you!  I would probably not be satisfied with the "it's probably this" and the "wait and see" approach... I am not that patient and have too much internet access.  :o)

Here is what I found - Be warned, some of it may or may not pertain to your situation, so you should rule out any other symptoms and maybe seek a few blood tests if necessary.  I don't think it's "that normal" for a 2 or 3 yr old to be exhibiting tremors, but of course, I'm not a doctor.  What you described sounds like "Task Specific Tremors", but you can read through the lists and see if there are any other tremors he shows.

I found this, which keeps the questions coming, but hopefully it can rule out a lot of conditions or give you direction in getting more answers.

http://pediatrics.about.com/od/weeklyquestion/a/04_tremors.htm


UNCOMMON TREMOR SYNDROMES AND TREMORS IN CHILDREN

Less common tremors include primary writing and other task-specific tremors 17 ; tremor secondary to peripheral neuropathies; and primary orthostatic tremor. 1,2 Tremors occasionally presenting during childhood include essential, enhanced physiologic, and primary writing tremors, and tremor following severe head injury. 20

A rare but important cause of tremor in the young is Wilson's disease*, an inborn error of copper metabolism that can be fatal if left untreated. Symptoms begin between 11 and 25 years of age, although they may present as early as 4 years of age. Tremor may be of the intention type or, more commonly, a wing-beating movement when the arm is abducted at the shoulder. Other signs are findings related to liver dysfunction and ring-shaped copper pigmentation in the cornea, called Kayser-Fleischer rings 21 (Table 5) . 3

The whole site is found here: Uncommon Tremor Syndromes - Tremors in Young Children
You will have to scroll pretty far down.

* I looked up Wilson Disease * since this was mentioned in the article above. You can rule this out by comparing any other symptoms or requesting a blood test.

Here is an excerpt:

Who gets Wilson disease?

People who get Wilson disease inherit two abnormal copies of the ATP7B gene, one from each parent. Wilson disease carriers, who have only one copy of the abnormal gene, do not have symptoms. Most people with Wilson disease have no known family history of the disease. A person’s chances of having Wilson disease increase if one or both parents have it.

About one in 40,000 people get Wilson disease.1 It equally affects men and women. Symptoms usually appear between ages 5 to 35, but new cases have been reported in people aged 2 to 72 years.

If you haven't already had one, I'd ask for an Intravenous Lead Draw.  Our state medicaid requires kids to have one at 1 yr and again at 3 yrs old in order to continue coverage.  It can give you some peace of mind to rule these things out... then you can feel better if you have to "wait and see".  There may be a few more illnesses associated with this symptom, and a little time on google may help you rule them out, and maybe help you get your SLP or OT to back off a little... or hell, have her come up with some possible reasons and stop spazzing out over it!  She is probably making your son uncomfortable... maybe SHE is the problem?

Sidenote: I have tremors when I wake up from a short nap... my whole body feels like it's being shocked... my kids have done this as well.  But this is one of those "not quite awake" tremors that goes away in a few seconds.  Not focus induced.

Good luck with finding your answers and please keep us posted. (have you joined my group? I don't come over here often)  Link in my siggy.

Found this on a message board:

Hand tremors in 6-year-old child

Oct 2005

Hi. I was wondering if anyone had information or experience with hand tremors in children. My 6 year old has had them for years. His physician says that they are no big deal and that he will probably outgrow them. His preschool teacher thought that it happened when he tried to hard. Time has passed and it has not changed. Now it is diffucult for him to write without the drawing shakey lines and to color. He is embarassed by his writing and tries to avoid it. Obviously I am very concerned and want to seek further evaluation. I will be contacting his physician and requesting a refferal to a Neurologist, if for nothing else a baseline. He is a very happy athletic guy. But his fine motor skills are lacking. Advice appreciated. Worried and want to be proactive.


I have a hand tremor and it was first given a diagnostic title by my pediatrician when I was 12, but I am sure that I had it before that. Mine has the fancy title ''Benign Essential Tremor of the Hand'' which means it's pretty much a big fat nuisance and nothing more except when I need to do something really anxiety provoking, like taking a final, and then it can get out of hand (so to speak).

I have had medication, Inderal, which is a beta blocker, for my tremor, since I was 12, and I have gone through periods of taking it and periods of not, including a 12 year hiatus while I was pregnant and breastfeeding my two boys. In my experience, my tremor bothers other people more than it does me.

I would go ahead and have a neurologist check it out to make sure it's not something else, but I have met a number of other people who have the same condition I do. It's weird but unrelated to anything like Parkinson's, so nothing to really worry about. heather

KGreene79
by Member on Apr. 7, 2009 at 7:21 PM

I will tell you that I just had  a discussion with my doctor about tremors TODAY! I have actually had tremors in my hands since childhood and I do not know why. I asked my doctor (who has 30 years of practice under his belt) about it. He said that some people just have them and there is no real explanation. He said that it can be genetic. Interestingly, my sister has tremors. I have noticed that Jackson is also shaky (my 19 mos old). Not as shaky as me, but he is more shaky than most babies in his hands. He is intense in personality and so am I. Is your son? Anyways, I just wanted to let you know that in our situation, it was nothing to worry about (although somewhat annoying). He said that it is common. If you are worried, it cannot hurt to get a second opinion. It might ease your mind. I would say, however, that I would trust a medical doctor's opinion on something like this over a SLP. Nonetheless, doctors are human and a second opinion can be valuable. Good luck!

daniavalentin
by New Member on Apr. 11, 2009 at 4:00 PM

It doesn't hurt to take the advice of your SLP. They deal with kids with neurological disorders on a regular basis and may be more familiar with some conditions that pediatricians may overlook. Ask your doctor for a referral because it is better to be safe than sorry. If it is something else, you can do something about it on time. If I had listened to my pediatrician about my son's speech delay I would still be struggling with my son's first words. She said he would catch up and he hasn't. Thank God I didn't listen and followed my instinct as a mom. Seth is 2 1/2 and he's taking Early Intervention therapy and he will start his speech therapy soon.

----- Visit my CafeMom homepage at http://www.cafemom.com/home/daniavalentin
campbell9310
by on Feb. 10, 2012 at 11:06 PM

I just took my son to the doctor due to tremors of the hands. They took some blood and the results for what they tested, came back normal. Did you ever find out what was the cause of your childs? If so, I would like to know. Thanks!

Kermitthemom23
by New Member on Feb. 13, 2012 at 11:20 PM

This is a really old post!!

My kid has them.  They caught it at his 2yo eval.  They made a big deal of it too.

I will say that it has never effected his abilities in PS and I don't even think he notices them at all.

I wasn't all that worried about it because I have them too.  As a fine/graphic artist it has occasional been a royal PITA for me, but I've learned to deal with it.  There is nothing what so ever wrong with me.

debator
by New Member on Apr. 16, 2012 at 5:09 PM

My grandbaby just got back from the ped and she is being referred to a neurologist.  My "Lillianna" has had tremors with her whole body but more noticeable in her little hands for quite some time.  I had heard that usually there is nothing to worry about.  However, I feel this ped wants to do this as a precaution.  I will keep u posted on the results I find.  I have just joined here and realize some time has passed since you made this post.  So, I am hoping you have many of your questions answered.  But, if not, hope the info i find will help you, as well.

Kermitthemom23
by New Member on Apr. 16, 2012 at 11:50 PM
Whole body tremirs and I would have taken the referal too. Hope all turns out well
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im_a_mommy_2
by New Member on May. 17, 2012 at 6:47 PM

Saw this was an old post was happy to see the thread picked up again.

I have a healthy 2 year old who started to have tremors in his hands this week.  We took him the pediatrician who said it was most likely a virus and that it would probably get better.  I looked online and saw many sites with posts describing the same problem.  In most cases, doctors and well-wishers had told moms it was probably nothing.  I find that a bit frustrating since it IS something.  The question is, is it something that requires treatment or is an indication of something bigger going on?

I investigated by taking my child to a pediatric neurologist and by doing a fair amount of research.  The upshot of my research is this:  the tremors indicate a symptomed called "ataxia" which is a difficulty of fine motor control.  There are a lot of causes for this ranging from mild self-limited conditions to severe conditions.  

The different causes are broken down into categories by whether they are a one-time thing, recurrent/episodic, or long-term.  Of course, the first presentation of a recurrent or long-term cannot be easily distinguished from a one-time thing, so usually, the diagnosis takes a while to firmly establish.  

The diagnoses are further divided depending on other symtpoms:  does the child have trouble walking as well as with fine motor control?  are there developmental delays?  symptoms suggesting infection?  symptoms equal in both sides or more on the other?  Any recent infections or immunizations?  Any family history of tremors or migraines?  Any chance the child ingested medications in the home or lead?

In our case, my child's symptoms were in both hands and he had a recent viral illness.  All of the other answers to the questions above were "no."  In this case, the most common cause (assuming this is a one-time deal) is that it is an "acute post-infectious cerebellitis" which in plain speak is inflammation of the cerebellum of the brain due to the immune system over-reacting after an infection.  The only atypical component is that it is just the hands (apparently is more commonly an abnormal gait that brings kids in for this).  Supposedly symptoms are the worst in the first 2-3 days and slowly get better over 2 weeks.  10% of kids have persistent symptoms, which when goes into adulthood can be mistakingly diagnosed as "benign essential" or "familial" tremor.

The pedi neurologist told us to bring him in if he develops any other neurologic symptoms as this would indicate it is likely another diagnosis.  98% of the diagnosis does not require lab tests or imaging.  In fact, there are too many lab tests to order given the number of conditions that produce these symptoms, so just getting some "standard labs' might not be helpful at all if they come back normal. 

So for all of you out there who are reading this, here is what I would recommend:

1.  Go to a pediatric neurologist.  Pediatricians will not know what to do with this.

2.  The most detailed description of actue cerebellar ataxia  can be found at http://www.uptodate.com/contents/acute-cerebellar-ataxia.  You have to pay for full access or you can have your MD print it out for you since most physicians pay for access to this site and use it to look up conditions.  

3.  Since the most common cause in a one-time case is self-limited and has no scary implications (other than the possibility of a persistent tremor) "just watching it" probably will have no ill effects.  But if there are any other symptoms that do not seem related to a neurologic problem (child smells funny, diarrhea, etc..) it may indicate something else.

4.  Above all, do not give up and feel frustrated.  There ARE people out there who think about these symptoms and think intelligently about it.  

Will add more if I learn more in my investigations.

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