Magnesium levels in serum and in C.S.F. in “meningo-encephalitic syndrome” (tremor syndrome)

Chhaparwal, B. C.; Singh, S. D.; Mehta, S; Pohowalla, J. N.

doi:10.1007/bf02760877

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…Some studies reported that boys are more commonly affected than girls, while few studied showed equal gender distribution in occurrence of ITS. 4,6 These three cases were presented with classical picture of ITS and were comparable to other cases described in literature. They were having tremor of acute onset, prominent in distal limbs and involving head & disappeared during sleep.…”

Section: Discussionsupporting

confidence: 83%

Infantile tremor syndrome

Brahmbhatt

Patel

Brahmbhatt³

2016

Int J Contemp Pediatr

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Investigations were suggestive of severe macrocytic hypochromic anaemia (Hb 6.4 gm%), RBC 2.48 mill/cmm, Mean corpuscular volume (MCV) 82 fl, Packed cell volume (PCV) 22.6%, Mean corpuscular hemoglobin (MCH) 26 pg, Mean corpuscular hemoglobin concentration (MCHC) 28.4%, Red blood cell distribution width (RDW) 26% with peripheral smear showing hypochromic macrocytic picture. Her serum calcium value was low (9.4 mg/dl), while Serum B12, Random Blood Sugar (RBS), serum TSH (Thyroid ABSTRACT Infantile tremor syndrome (ITS) is a clinical entity characterized by tremors, skin pigmentation, anemia, developmental and mental retardation. It is most commonly found in Indian subcontinent and in children who are exclusively on breast feeding of vegetarian mother. Amongst all the etiological theories, nutritional theory is the most accepted one. Management of ITS is largely empirical and includes therapy of nutritional deficiency, anemia & tremors apart from appropriate care. Treatment of nutritional deficiency includes vitamin B12, multivitamins, folic acid, iron, calcium, zinc, magnesium and high protein diet. In this article, three cases of ITS with classical picture have been reported.

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Section: Discussionsupporting

confidence: 83%

Infantile tremor syndrome

Brahmbhatt

Patel

Brahmbhatt³

2016

Int J Contemp Pediatr

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“…Chhaparwal et al . [ 19 ] and Agarwal et al . [ 20 ] have shown the association of tremors with low magnesium levels.…”

Section: Discussionmentioning

confidence: 99%

Infantile tremor syndrome in modern times

et al. 2017

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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.

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“…[ 2 ] Low serum albumin has been found in small number of infants with ITS in many studies. Deficiency of magnesium[ 24 25 ] and zinc[ 25 26 ] has been reported. Garewal et al .…”

Section: Laboratory Investigationsmentioning

confidence: 99%

“…It is beyond any reasonable doubt that infants with ITS are malnourished, a fact that is agreed on by almost all the researchers. [ 1 3 4 5 6 8 9 11 12 15 16 20 ] Of all the specific nutrients, deficiencies of zinc and magnesium have been found in ITS,[ 24 25 26 ] but the clinical picture associated with these deficiencies bears no resemblance to that of ITS. These deficiencies are therefore likely incidental to the malnutrition that is observed in ITS rather than being causative.…”

Section: Unknown or Multiple Etiologiesmentioning

confidence: 99%

Infantile tremor syndrome: A review and critical appraisal of its etiology

Goraya

Kaur

2016

J Pediatr Neurosci

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Infantile tremor syndrome (ITS) is defined by the tetrad of pallor, developmental delay/regression, skin pigmentation, and brown scanty scalp hair. Involuntary movements in the form of tremors supervene in the natural course of the illness in a significant number of cases. The disorder occurs in exclusively breast-fed infants of vegetarian mothers belonging to economically deprived sections of society. Most of the children eventually recover but are frequently left with long-term cognitive and language neurodeficits. ITS continues to be seen in clinical practice, but there has been no consensus on its causation. Last comprehensive review was published in 1987 describing the ITS as a syndrome of unknown or multiple etiologies. Several important papers have been published since then. This review attempts to provide comprehensive and up-to-date information on the subject incorporating recently published studies. In the end, the issue of etiology is objectively re-examined in the light of available evidence some of which has been published in recent years.

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Magnesium levels in serum and in C.S.F. in “meningo-encephalitic syndrome” (tremor syndrome)

Cited by 8 publications

References 7 publications

Infantile tremor syndrome

Infantile tremor syndrome

Infantile tremor syndrome in modern times

Infantile tremor syndrome: A review and critical appraisal of its etiology

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