14 months old child presented with tremulus movement in lt upper limb and tongue,globally delayed milestones(mental age=5 months,motor age6 months)with pem kwash,dolichocephaly and ascitis. Clinically positive findings are -dolichocephaly +,head circumference normal for age,generalised edema +,mild pallor+,dark pigmentation of knuckels +,nails shape - abnormal,shifting dullness +,no organomegaly investigation showed raised mcv, decreased albumin,urine normal,stools normal,b12level normal mri- brain reported mildly enlarged ventricles,cortex normal. What it is ? Infantile tremor syndrome ? If yes how to approach this child ?what is the treatment for tremors ? How long it will take to disappear after starting treatment? What will be prognosis of child ?
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