Differential Diagnosis for a 9-Month-Old Waking Up from Sleep Shaking
- Single Most Likely Diagnosis + Febrile seizure: This is a common condition in infants and young children, typically occurring between 6 months and 5 years of age. The shaking could be a seizure caused by a fever, which is a frequent trigger in this age group.
- Other Likely Diagnoses + Night terror or sleep terror: Although night terrors are more common in older children, they can occur in infants. The child might appear to be shaking or trembling during a night terror, but they are usually unresponsive and have no memory of the event in the morning. + Sleep myoclonus: This is a benign condition characterized by sudden, brief contractions of the muscles during sleep, which could be mistaken for shaking. + Teething pain: While not typically causing shaking, severe teething pain could potentially wake a child and cause distress that might be misinterpreted as shaking.
- Do Not Miss Diagnoses + Meningitis or sepsis: These are severe infections that can cause seizures, including those that occur during sleep. Early recognition and treatment are crucial to prevent serious complications or death. + Hypoglycemia: Low blood sugar can cause seizures, especially in infants who have limited glycogen stores. This condition requires immediate attention to prevent brain damage. + Epilepsy: Although less common, epilepsy should be considered, especially if there's a family history or if the child has had previous seizures.
- Rare Diagnoses + Infantile spasms: A rare and serious form of epilepsy that typically begins within the first year of life. It is characterized by brief, but often frequent, spasms. + Benign familial neonatal epilepsy: A rare genetic disorder that causes seizures, typically starting in the first few weeks of life, but can sometimes present later. + Metabolic disorders: Certain metabolic disorders can cause seizures, including those that occur during sleep. These are rare but important to diagnose early for proper management.