From the Guidelines
The exact cause of essential tremor in children is unknown, but genetics plays a significant role with about 50-70% of cases having a family history. Essential tremor in children is believed to result from abnormal electrical activity in parts of the brain that control movement, particularly the cerebellum, thalamus, and motor cortex. While the condition is often inherited in an autosomal dominant pattern (meaning a child needs only one copy of the mutated gene from either parent to develop the condition), specific gene mutations have been identified in some cases. Environmental factors may also contribute to the development of essential tremor in genetically predisposed children. Unlike Parkinson's disease, essential tremor is not caused by a loss of dopamine-producing cells. The tremors typically affect the hands, head, and voice, and are most noticeable during voluntary movement rather than at rest. The tremors often worsen with stress, fatigue, certain medications, caffeine, and as the child grows older.
Some key points to consider in the management of essential tremor in children include:
- Genetics plays a significant role in the development of essential tremor
- Abnormal electrical activity in the brain contributes to the condition
- Environmental factors may also contribute to the development of essential tremor
- The condition is not life-threatening, but can significantly impact a child's daily activities and quality of life if severe
- Treatment options, such as beta-blockers like propranolol 1, may be effective in managing symptoms.
It's worth noting that while beta-blockers like propranolol have been used to treat essential tremor for more than 40 years 1, the exact cause of the condition remains unknown. Further research is needed to fully understand the underlying mechanisms of essential tremor in children.
From the Research
Causes of Essential Tremor in Children
The exact cause of essential tremor in children is not fully understood, but several factors are thought to contribute to its development.
- Genetic factors: Studies have shown that essential tremor can run in families, suggesting a possible genetic component 2.
- Environmental factors: Exposure to certain environmental toxins, such as beta-carboline alkaloids, may also play a role in the development of essential tremor 2.
- Neurological factors: Essential tremor is thought to involve abnormal activity in the brain's motor control systems, including the cortico-olivo-cerebello-thalamic circuit 2.
- Other possible causes: Some research suggests that essential tremor may be related to other conditions, such as cognitive impairment, psychiatric disorders, and hearing loss 3.
Current Understanding of Essential Tremor
Essential tremor is a common movement disorder that can affect both children and adults.
- Diagnosis: The diagnosis of essential tremor is typically based on the presence of an isolated action tremor in the bilateral upper extremities for at least three years 3.
- Treatment: Treatment options for essential tremor include pharmacotherapy with propranolol or primidone, botulinum toxin injections, and surgical interventions such as deep brain stimulation 4, 5, 3.
- Classification: Essential tremor can be classified into different subgroups, including "essential tremor plus," which refers to patients with associated subtle neurological "soft signs" 5, 3.