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Journal of Pediatric Epilepsy 2021; 10(01): 033-034
DOI: 10.1055/s-0040-1718524
Case Report

Shuddering Attacks in an Infant

Roshan Koul
1   Department of Pediatric Neurology, Institute of Liver and Biliary Sciences, New Delhi, India
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Abstract

Shuddering attacks are rare benign nonepileptic paroxysmal events (NEPEs) seen in infancy and early childhood. These movements may look like myoclonus or infantile spasms. Recognition of these movements is important to avoid elaborate workup and antiepileptic medications. Shuddering attacks disappear by the age of 2 years in most of these children. NEPEs are almost as common as epilepsy. It is easy to differentiate the common NEPEs from epilepsy. However, it is difficult to diagnose the rare benign NEPEs not seen before. Shuddering attacks are one of these rare NEPEs. It is commonly diagnosed as infantile spasms/myoclonus unless one observes the actual event or video very carefully.

Keywords

shuddering attacks - infantile spasms - epilepsy - infancy - benign nonepileptic paroxysmal events


Publication History

Received: 03 August 2020

Accepted: 07 September 2020

Article published online:
26 October 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Hrastovec A, Hostnik T, Neubauer D. Benign convulsions in newborns and infants: occurrence, clinical course and prognosis. Eur J Paediatr Neurol 2012; 16 (01) 64-73
    CrossrefPubMedGoogle Scholar
  • 2 Laux L, Nordli DR. Nonepileptic spells in neonates and infants. In: Kaplan WK, Fisher RS. eds. Imitators of Epilepsy. 2nd ed.. New York: Demos; 2005: 83-84
    Google Scholar
  • 3 Rothner AD. ‘Not everything that shakes is epilepsy.’ The differential diagnosis of paroxysmal nonepileptiform disorders. Cleve Clin J Med 1989; 56 (Suppl Pt 2): S206-S213
    CrossrefPubMedGoogle Scholar
  • 4 Tibussek D, Karenfort M, Mayatepek E, Assmann B. Clinical reasoning: shuddering attacks in infancy. Neurology 2008; 70 (13) e38-e41
    CrossrefPubMedGoogle Scholar
  • 5 Fernández-Alvarez E. Transient benign paroxysmal movement disorders in infancy. Eur J Paediatr Neurol 2018; 22 (02) 230-237
    CrossrefPubMedGoogle Scholar
  • 6 Jan MM. Shuddering attacks are not related to essential tremor. J Child Neurol 2010; 25 (07) 881-883
    CrossrefPubMedGoogle Scholar
  • 7 Bye AM, Kok DJ, Ferenschild FT, Vles JS. Paroxysmal non-epileptic events in children: a retrospective study over a period of 10 years. J Paediatr Child Health 2000; 36 (03) 244-248
    CrossrefPubMedGoogle Scholar
  • 8 Kanazawa O. Shuddering attacks-report of four children. Pediatr Neurol 2000; 23 (05) 421-424
    CrossrefPubMedGoogle Scholar
  • 9 Vanasse M, Bedard P, Andermann F. Shuddering attacks in children: an early clinical manifestation of essential tremor. Neurology 1976; 26 (11) 1027-1030
    CrossrefPubMedGoogle Scholar
  • 10 Jankovic J, Madisetty J, Vuong KD. Essential tremor among children. Pediatrics 2004; 114 (05) 1203-1205
    CrossrefPubMedGoogle Scholar