Tremulous Movement in Left Upper Limb

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Infantile Tremor Syndrome

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
14 months old child presented with tremulous movement in left upper limb and tongue ,globally delayed milestones(mental age=5 months,motor age6 months)with pem kwash,dolichocephaly and ascites. Clinically positive findings are -dolichocephaly +,head circumference normal for age, generalised edema +,mild pallo r+,dark pigmentation of knuckles +,nails shape - abnormal, shifting dullness +,no organomegaly investigation showed raised mcv, decreased albumin, urine normal, stools normal,b12level normal MRI of the brain reported mildly enlarged ventricles, cortex normal. What 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?
Answer
Yes, infantile tremor syndrome can be a possibility. What is important is to know the diet of the child. Is the child predominantly on breast feeding? If yes, then B12 levels in the mother must be done and if low then both mother and child should be treated with high dose vitamin b12 for 7-14 days. Also give folate and zinc supplements. Response in ITS occurs dramatically and tremors may stop in 3-4 days but improvement in mental delay may not be as good. Back to All Questions

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