Tremors are rhythmic, oscillating muscle movements pivoting on a joint. They most commonly involve the hands but can affect the arms, head, vocal cords, trunk, or legs. They may be constant or can come and go. They may be a single condition or the result of another.
They are most common in people middle-aged or over but can occur in children and adolescents. Most tremors are more embarrassing than debilitating but should be examined by a physician either way.
Although there are 20 different types of tremors, several that affect children are jitteriness of newborns—usually resolving in the first few weeks of life in healthy term infants; shuddering—often occurring many times a day and resulting from excitement, frustration, embarrassment, or surprise; enhanced physiologic tremor—usually a two-handed tremor, triggered by excitement, anxiety, fatigue, fever, or hunger; and essential tremor—usually an adult tremor but occasionally seen in children, mainly in the arms and during some sort of activity. A family history is regularly seen with essential tremor.
Medications such as antiepileptics, beta adrenergics, immunosuppressants, and antidepressants also may cause tremors. Secondary causes may include hypoglycemia, hyponatremia, hypocalcemia, or hypomagnesemia.
In most cases, tremors in children have no serious, progressive, underlying condition, but when they occur, a thorough diagnostic evaluation should be made.