Shuddering Attacks Are Not Related to Essential Tremor

Abstract

Shuddering attacks are benign shivering movements occurring in young children. The etiology is unknown; however, a relationship to essential tremor has been postulated. A series of 12 consecutive children were identified over a 6-year period ending January 1, 2007. Shuddering attacks were diagnosed based on descriptive history and videotape review. Their referral diagnosis was epilepsy in 7 (58%) and movement disorder in 5 (42%). The referring physician never suspected the diagnosis. The age of onset ranged from 8 months to 2 years (mean 13 months). Family history was negative for essential tremor. None had epileptiform discharges on electroencephalography (EEG). All children were followed for 2 to 8 years (mean 6.3). Complete remission was noted by 3 to 7 years (mean 5.6) of age, and none had subsequent tremor during follow-up. In conclusion, shuddering attacks are frequently misdiagnosed leading to unnecessary investigations or treatment. No association with essential tremor was found neither in the child nor in the family.