Infantile tremor syndrome: current perspectives

Abstract

Rajesh Gupta,1 AK Rawat,2 Poonam Singh,3 Jyoti Gupta,4 Ashish Pathak5–71Department of Paediatrics, Government Medical College, Datia, MP, India; 2Department of Paediatrics (Formerly), Bundelkhand Medical College, Sagar, MP, India; 3Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India; 4Department of Microbiology, Chirayu Medical College, Bhopal, MP, India; 5Department of Paediatrics, R.D. Gardi Medical College, Ujjain, MP, India; 6Global health (IHCAR)/Department of Public Health Science Karolinska Institutet, Stockholm 171 77, Sweden; 7Department of Women and Children’s Health, IMCH, Uppsala University, Uppsala, SwedenAbstract: 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.Keywords: tremors, infantile tremor syndrome, undernutrition, vitamin B12

Keywords

• Tremors
• Infantile Tremor Syndrome
• Undernutrition
• Vitamin B12