Infantile tremor syndrome in modern times

Abstract

Background:Infantile tremor syndrome (ITS) is a clinical syndrome of acute or gradual onset of mental and psychomotor changes, pigmentary disturbances of hair and skin, pallor, and tremors in malnourished children aged between 5 months and 3 years. It is a well-known entity, but the exact etiopathogenesis is still not known.Setting and Design:Prospective observational study carried out in the Department of Pediatrics at Dr RPGMC Tanda, Kangra in Himachal Pradesh.Materials and Methods:Demographic, clinical, and laboratory profile of 25 children with the diagnosis of preinfantile and ITS was collected who were admitted from May 2014 to June 2015.Statistical Analysis:Descriptive analysis was performed using SPSS 17 trial version.Results:These children accounted for 0.5% of total pediatric admissions. Median, standard deviation age was 10, 3.1 months. Male to female ratio was 1.27:1. Cases were present throughout the year with two peaks observed in the months of May and November. This disease was found to be more common in higher birth order (68%). Complementary feeding, that too improper, was initiated in only 4 cases (16%). Ninety-six percent cases presented with comorbid illnesses. Respiratory tract infection was the most common association, followed by urinary tract infection. There was moderate anemia with dimorphic picture (40%). Thirteen (52%) had vitamin B12 levels below normal. Magnesium levels, though statistically insignificant (P = 0.8) were lower in patients with tremors.Conclusion:This is a disease of multi-micronutrient deficiency, which can be present either alone or in association. Educating women about proper nutrition during pregnancy and timely administration of complementary feeding is of utmost importance.

Infantile tremor syndrome with global developmental delay and microcephaly in a 16-month-old male: a case report

“…Goraya et al 7 , in their review, highlighted the significant efficacy of vitamin B12 treatment alone in achieving notable recovery in haematological and neurological symptoms. Similar results were reported by Saraswat et al and Gautam et al 19 , 20 and in all these studies, besides vitamin B12 supplementation, the overall approach included addressing coexisting protein energy malnutrition and infections, along with providing counselling to parents regarding appropriate weaning practices. For treating tremors in ITS in the context of vitamin B12 deficiency, Cyr et al 4 used propanolol due to its relatively safe side effect profile compared to sedatives and anti-convulasants, which resulted in significant improvement without any adverse reactions.…”

<p>Infantile tremor syndrome: current perspectives</p>

“…In a study of 67 infants with ITS admitted over a period of 4 years, majority (52%) of cases have been reported from May to July 21. However, some researchers found cases throughout the year with two peaks in May and November 22,23…”