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

Abstract

Infantile Tremor Syndrome (ITS) is a self-limiting clinical state characterized by tremors, anemia, pigmentary skin disease, regression of mental development, and hypotonia of muscles in a plump looking child. Tremors are coarse in character, decreased or disappeared in sleep and resolves within 4–6 weeks in its natural course. Various etiological factors as infectious, metabolic, nutritional have been hypothesized but none is conclusive. Consensus is developing on the role of Vitamin B12 deficiency in children with ITS but is still debatable. Empirical management of ITS children has been tried in the absence of exact etiology considering child as undernourished. Nutritional management includes supplementation of Iron, Calcium, Magnesium, Vitamin B12 and other multivitamins. Tremors can be managed with administration of propranolol most commonly or phenobarbitone, phenytoin, and carbamazepine.

Clinical profile of patients with infantile tremor syndrome in a tertiary care center

“…ITS is a clinical state which is characterized by tremors in form of rhythmic, coarse, twitching of the angles of eye, mouth, eyelids and tongue with a tremulous cry resembling bleating of a goat, tossing movement of the head, wriggling movements of the trunk and coarse rhythmic continuous rapid movements of varying but usually of low amplitude in the extremities, most marked in the distal parts especially the fingers along with anemia, dull apathetic look, sparse scalp hair, expressionless face with drooling of saliva, pigmentation over extremities, mild hepatomegaly with or without splenomegaly, regression of mental development and hypotonia of muscles. 3 It is prevalent in age group of 6 months to 3 years, with maximum number of patients belonging to age range of 6 months to 24 months, similar to our study. Males are more affected than females, with increase in incidence with increasing birth order, as was seen in our study.…”

“…It is noted that those breast fed by strict vegetarian mothers have more propensity to develop ITS. 3 It is combined result of poverty, ignorance and lack of nutritional advice which was also noted in our study. 2 Anemia is a prominent feature in ITS and was present in all patients of our study.…”

“…Pre-tremor stage: neuro motor regression, pallor, sometimes tremulous voice, tremor stage: sudden onset of tremors and post tremor stage: resolution of tremors. 3 Tremors in ITS involve various parts of the body, mainly extremities of hands and feet. Tremors are coarse in character, decreased or disappeared in sleep.…”

“…Few cases have been reported in Africa and South East Asia. 2,3 ITS was first described by Dikshit at Hyderabad, India, in 1957 who named it as 'nutritional dystrophy and anemia'. 2 The aim of study was observing the clinical profile of patients having infantile tremor syndrome and its relation to vitamin B12 levels along with response to treatment and final outcome.…”

Self‐catalytic mechanism of prebiotic reactions: From formamide to purine bases

“…Later, several theoretical papers on the mechanism of adenine, cytosine, thymine, uracil, and guanine formation under extraterrestrial nonaqueous scenarios have been also published. [ 16–19 ] Gupta et al [ 16 ] report results from B3LYP/6‐31G** calculations for the formation of adenine via successive reactions, starting from hydrogen cyanide, cyanocarbene, cyanamide, and cyanide radical. Тhe reaction path is found to be exothermic and barrier free.…”