Neonatal tremor

Introduction Pediatric cerebral tremors may occur due to imperfect development of the nervous system. This episode does not affect the child's sleep and spirit. Beating or diverting attention will quickly terminate the episode and have no effect on the child's growth and development. As the nervous system develops, it gradually disappears. However, there may be some pathological seizure factors, which can be divided into febrile seizures and athermal convulsions according to clinical manifestations, while central nervous system diseases and metabolic abnormalities such as vitamin D deficiency hypocalcemia, hypoglycemia and vitamin B6 deficiency. Waiting for it will cause the child to have a seizure.

Cause

Neonatal tremor may be caused by central nervous system diseases, metabolic abnormalities such as vitamin D deficiency hypocalcemia, hypoglycemia and vitamin B6 deficiency caused by convulsions in children.

an examination

Related inspection

Neurological examination of blood routine

Do a check to rule out the diseases of the nervous system, combined with the child's feeding and physical signs, check blood calcium levels and bone-derived alkaline phosphatase, to determine whether you have vitamin D deficiency rickets, and timely treatment.

Resting tremor: tremor occurs when it is at rest, such as "pill-like". Seen in Parkinson's disease (Parkinson)

Intentional tremor: occurs in exercise, the closer the purpose is more obvious, found in cerebellar lesions, and idiopathic tremor is also called familial, hereditary benign tremor.

Flapping tremor: seen in early liver coma, chronic liver disease.

Differential diagnosis

Differential diagnosis of neonatal tremor:

1. Physiological sleep myoclonus: It is common in normal people. It is seen in the early stage of sleep and REM sleep. It is usually characterized by facial muscle contraction and short-term movement of the fingers or toes. It can also appear in the whole body or side during the shallow sleep. The large muscles of the limbs are twitching, mainly involving the lower limbs, like a feeling of falling. The EEG is normal, or a paroxysmal high-amplitude slow wave similar to the K-complex wave appears, but there are no spines and sharp waves. Often cause an awakening reaction.

2, startle reaction: clinical common symptoms, caused by sudden sensory stimulation of bilateral gross muscle clonic twitching, similar to excessive Mom reflex, can be found in normal infants, need to be differentiated from reflex epilepsy. The nature of a normal startle response is different from that of excessive Mom reflection or pathological stimulation-induced myoclonus, which is often accompanied by resting or progressive encephalopathy.

3, early benign myoclonus in infants: also known as benign nonpilepsy infantile spasms (benign nonepilepfic infantile spasms), children with repeated neck and upper extremity twitching, causing head and shoulder shaking, slight exercise only involved Upper limbs, occasionally symmetrical or asymmetrical flexion or extension-like movements of the head and upper limbs. The twitching can be single or continuous, and the episodes occur several times a day, but generally there is no episode of sleep. At the time of onset, the child's consciousness is not damaged, the reaction is normal, and sometimes it can be induced by feeding. The age of BMEI is 1 to 12 months, 90% is 3 to 9 months, which overlaps with the age of onset of infantile spasm. It is easy to confuse the two. Nervous system examination and laboratory examination are normal, EEG is normal during the interictal and episodes, behavior and neurodevelopment are normal, symptoms usually disappear after 12 to 18 months, and the long-term prognosis is good, which can be differentiated from infantile spasms. This disease does not require treatment.

4, benign neonatal sleep myoclonus: onset within 1 month after birth, myoclonus mainly involves the forearm and hands, but also affect the foot, face, trunk or abdominal muscles. Most of them appear in the NREM stage of sleep, REM period is rare, and even can be induced by sound and other stimuli. Myoclonus can be bilateral, local or multifocal, with rhythm or arrhythmia, often appearing in groups of 1 to 5 e/s for several seconds. This series of myoclonic twitching can occur repeatedly during sleep for 20 to 30 minutes, or up to 90 minutes, and can be mistaken for convulsions. Nervous system examination and EEG are normal. Occasionally family history. Symptoms are relieved after 2 months of birth and disappear 6 months later. Long-term prognosis is good and no treatment is needed.

5, cerebellar lesions: the physiological function of the human cerebellum is mainly to maintain body balance and coordinate random movement. Cerebellar lesions cause muscle tension to be low, causing limbs to soften, and the distance to exercise, the speed of movement, and the strength required for exercise are underestimated, and irregular limb tremors can occur.

6, idiopathic tremor: also known as familial idiopathic tremor, hereditary benign tremor, is an autosomal dominant genetic disease, the most common extrapyramidal disease, is also the most common tremor, about 60% The patient has a family history. Idiopathic tremor is a single symptomatic disease, and postural tremor is the only clinical manifestation of this disease. The so-called posture tremor refers to the tremor caused by the limb maintaining a certain posture, and the tremor naturally disappears when the limb is completely relaxed. The tremor of this disease is common in the hand, followed by head tremor, and very few patients have lower limb tremor. The tremor of the disease is aggravated by concentration, nervousness, fatigue, and hunger. Most cases temporarily disappear after drinking, and the next day is aggravated. This is also a characteristic of idiopathic tremor. Coping treatment.

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