Tremors in Infantile Tremor Syndrome Mimicking Epilepsia Partialis Continua

Abstract

A 19-month-old male was referred to us with acute febrile illness and respiratory distressfollowed by continuous jerky movements. The parents described them as abnormal movements beginning in the left upper limb, then left lower limb in the next two days, followed by spread to the whole body, including the tongue, eyes and the head by the end of the week.These movements increased during periods of crying or agitation, and subsided in sleep. He was third born tonon-consanguineous parents and was exclusively breastfed. He had a pre-existing mild developmental delay. On examination, he was underweight (weight 5kg, <-3z score), stunted (length 67cm, <-3z score), and microcephalic (head circumference 42.8cm, <-3z score) with a dull, expressionless face. There was pallor, sparse hypopigmented hair, and hyperpigmentation of the skin, especially over the dorsum of hands and feet, and over bony prominences (Figure 1). He hadnear-continuous, involuntary,abnormal, hyperkinetic, shaking, to