The most common postural tremor in children is
called an Essential Tremor, or Benign Tremor.
It may occur at any age, but it is more common in
the second and sixth decades of life. About half of
patients with essential tremor have a family history
of this type of tremor. Fortunately, an Essential
Tremor is treatable and seldom a sign of a serious
Write it Right
Tremor is an involuntary shake that affects about 4 million Americans. The most common tremor involves the hands. But it can also affect the head, face, or voice. Tremor in children is usually benign and although it is not life-threatening, it can • Cocaine or alcohol exposure during the • Cerebral Palsy• Traumatic Brain Injuries• Cerebellar disease• Peripheral Neuropathy Types of Tremor
• Thyroid Disease• Parkinson's disease• Alcoholism example, when the hands are lying on the table.
Postural tremor occurs when
Can a tremor
be normal?
Intention or Kinetic tremor
Everyone has a normal or physiologic tremor. A physiologic tremor is very mild and often cannot be detected except by a doctor. Anxiety, caffeine, fatigue, or medications may worsen a physiologic tremor. The tremor may worsen when you engage in mental tasks (like studying or • Task specific tremor occurs
playing video games) or if you move another part of the body, such as clenching a fist or tapping a Provokers
Before treating a tremor, a thorough evaluation including a history and a physical exam is done. Thyroid tests, MRI, EMG, or an ophthalmology • Cold medicines like Actifed or Sudafed consultation may be requested. Medication should be used only when a tremor interferes with a patient's ability to function. If a medication is causing the tremor, the best treatment is to • Neuroleptics like Risperdal, or Haldol change or stop that medicine if possible. A • Other medicines like Tegretol, Depakote, common side effect with medications used to treat tremor is drowsiness. Treatments include: • Foods like caffeine or chocolate• Low blood sugar from skipping meals • Inderal (propranolol), a blood pressure
medicine, and Mysoline (primidone) are
the medications of choice.
• Baclofen and Zanaflex are muscle
• Neurontin is a seizure medicine.
• Klonopin is used for postural tremors.
• Artane or Cogentin can help especially
• Diamox, a diuretic, has helped some.
• Botox is an injected medicine that has
• Brain surgery has helped many patients School Help
For school children, an IEP (Individual Education Plan) can be written. This may include: • Decrease the amount of written work.
• Use multiple choice or circle the answer Check it out
• Do not grade them on their penmanship.
International Tremor Foundation
• Use a tape recorder to take notes.
• Allow oral rather than written reports.
• Have them dictate their reports to a "secretary" (a parent or a friend) who can write down their thoughts for them. • An Occupational Therapist helps develop strategies for writing, eating, or dressing.
Written by Don Eastmead, M.D. & edited by Drew Eastmead June 2004


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