Pediatric Tremors and Tics

Pediatric Tremors and Tics

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Summary

Pediatric Tremors and tics cause involuntary, often unusual, muscle movements that are part of a larger movement disorder class called dyskinesia.

Expanded overview

Tremors are involuntary (cannot be controlled), rhythmic movements of the body. Movement associated with a tremor is often a back-and-forth type movement of one or more body parts. Most commonly, tremors affect the hands. They can also occur in the arms, head, face, vocal cords, trunk and legs. Tremors can occur while the child is resting or active.

Tics are spasm-like movements of certain muscles in the body, most often the eyelids or face. They are often repetitive, with multiple successive occurrences of the same unusual action. In most cases, tics are harmless and temporary. However, they can be caused by a tic disorder. Tics are much more likely to affect males than females, and they are fairly common in children.

Causes

In children, tremors are most commonly idiopathic (have no known cause), but they can also occur due to several possible triggers, including:

  • Damage to the thalamus (brain structure that controls muscle activity) 
  • Genetics 
  • Head trauma 
  • Illness (multiple sclerosis or Parkinson’s disease) 
  • Kidney or liver failure 
  • Mercury poisoning 
  • Overactive thyroid (hormone gland that controls metabolism) 
  • Psychological trauma 
  • Side effect of medicine 
  • Stroke 

Types

There are two types of tics

  • Motor (physical movement)
  • Vocal (speech or sounds)

Classifications of tremors

The main classifications of tremors include:

  • Sustentation tremor – This type occurs when the child holds their arms out in front of their body.
  • Action tremor – This type occurs when the child is undertaking activities, such as writing, drinking from or pouring from a cup, or drawing.
  • Intention tremor – This type occurs when the child is asked to touch his or her finger to their nose.
  • Rubral tremor – Also known as wing-beating, this type occurs when the child flexes the arms to allow index fingers to touch.

Symptoms

Symptoms of tremors and tics vary based on the specific type of tremor or tic. Sudden muscle movements that interrupt otherwise seemingly normal behavior, activity or speech are the hallmarks of these conditions. Tremors may occur alongside other symptoms like limb weakness, speech impairment or fine motor issues (pinching, winking and other small movements). 

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