Tremor in School-Aged Children: A Cross-Sectional Study of Tremor in 819 Boys and Girls in Burgos, Spain

Louis, Elan D.; Cubo, Esther; Trejo-Gabriel-Galán, J.M.; Villaverde, Vanesa Ausín; Benito, Vanesa Delgado; Velasco, Sara Sáez; Vicente, Jesús Mac Arrón; Guevara, José Cordero; Benito‐León, Julián

doi:10.1159/000330352

Cited by 17 publications

(27 citation statements)

References 33 publications

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“…Tremor ratings, published previously (Louis et al, 2011, 2015) for each spiral were: 0 (no tremor), 0.5 (subtle, low amplitude oscillations are present in a few spots but are not consistently present throughout the spiral), 1.0 (low amplitude oscillations are present in multiple places), 1.5 (low amplitude oscillations are present in multiple places and oscillations can at times reach moderate amplitude), 2 (moderate amplitude oscillations present throughout the spiral) (for examples of rated spirals, see Figs. 2–4 in Louis et al, 2015).…”

Section: Methodsmentioning

confidence: 99%

Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor

et al. 2015

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Background The organophosphate insecticide chlorpyrifos (CPF), widely used for agricultural purposes, has been linked to neurodevelopmental deficits. Possible motor effects at low to moderate levels of exposure have not been evaluated. Methods Prenatal exposure to CPF was measured in umbilical cord blood in a sample of 263 inner-city minority children, who were followed prospectively. At approximately 11 years of age (mean age 10.9 ± 0.85 years, range = 9.0–13.9), during a neuropsychological assessment, children were asked to draw Archimedes spirals. These were rated by a senior neurologist specializing in movement disorders who was blind to CPF exposure level. Results Compared to all other children, those with prenatal CPF exposure in the upper quartile range (n = 43) were more likely to exhibit mild or mild to moderate tremor (≥1) in either arm (p = 0.03), both arms (p = 0.02), the dominant arm (p = 0.01), and the non-dominant arm (p = 0.055). Logistic regression analyses showed significant CPF effects on tremor in both arms, either arm, the dominant arm (p-values < 0.05), and the non-dominant arm (p = 0.06), after adjustment for sex, age at testing, ethnicity, and medication. Conclusion Prenatal CPF exposure is associated with tremor in middle childhood, which may be a sign of the insecticide's effects on nervous system function.

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Section: Methodsmentioning

confidence: 99%

Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor

et al. 2015

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“…who was blinded to all clinical information. Tremor ratings, published previously, 4 for each spiral were: 0 (no tremor), 0.5 (subtle, low amplitude oscillations are present in a few spots but are not consistently present throughout the spiral), 1.0 (low amplitude oscillations are present in multiple places), 1.5 (low amplitude oscillations are present in multiple places and oscillations can at times reach moderate amplitude), 2 (moderate amplitude oscillations present throughout the spiral) (for examples of rated spirals, see Figures 2, 3 and 4 in 4 as well as Figure 1 in this report). We have previously shown in a study in which 200 spirals were rated by four raters that the inter-rater agreement between the senior movement disorder and three other raters was high (interclass correlation coefficients = 0.67 – 0.74, p < 0.001).…”

Section: Methodsmentioning

confidence: 99%

“…Curiously, there have been virtually no surveys of the prevalence, clinical features or correlates of tremor among children. 4 In 2000, nearly 1 in 4 (i.e. 24.0%) people in the United States were under age 18 years; 5 hence, the health of this age group, which also forms the core of the future adult population, is of considerable importance.…”

Section: Introductionmentioning

confidence: 99%

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Tremor in a Population-Based Cohort of Children in New York City

Louis

Garcia

Rauh

2015

Pediatric Neurology

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Background There have been virtually no surveys of the prevalence, clinical features or correlates of tremor in children, and none in the United States. Methods 317 children (age 11.0 ± 1.1 years, range = 9.0 – 14.7) underwent an evaluation at one time point. Each drew Archimedes spirals, which were rated by a senior neurologist specializing in movement disorders. Results A spiral score of 1 (mild but consistent tremor) was present in either hand in 105 (33.1%) children; a higher score (1.5, mild to moderate tremor) was present in either hand in 7 (2.2%) children. Higher spiral scores were associated with poorer motor hand function as assessed using the Purdue Pegboard test. Spiral scores were higher in boys than girls, were inversely associated with age, and were higher in the non-dominant than dominant hand. Spiral scores were highest in children who were taking psychiatric medications and in children with psychiatric or neurological disorders. Conclusions Mild tremor is common in children, and covaries significantly with several demographic and clinical factors as well as usage of certain medications. It also lessens with advancing age. Rather than an isolated finding, tremor was associated with other measures of poorer motor hand function.

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“…1 In a crosssectional study involving 819 school-aged children in Spain, the prevalence of tremor was evaluated through the assessment of spiral drawings; mild to moderate tremor was observed in 2.1% of the children. 2 Tremor is defined as a rhythmic and sinusoidal movement produced by reciprocally innervated antagonist muscles. The rhythmicity of tremor is the most recognizable feature and distinguishes it from other pediatric movement disorders.…”

Section: Discussionmentioning

confidence: 99%

Two children with tremor

Liu

Pringsheim

Thompson

2014

CMAJ

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A right-handed 14-year-old boy was referred to a neurologist for an outpatient evaluation of tremor. The boy was previously healthy and not taking any medications. Developmental milestones were achieved within the appropriate norms. There was a family history of tremor in the boy's mother and maternal uncle. The mother reported that her tremor lessened following the consumption of alcohol. The parents first noticed the tremor in their son when he was about six years old. The tremor occurred mainly during voluntary activity, such as writing, eating soup with a spoon, drinking from a cup and using his hands for small skilled movements. The tremor affected both arms and was worse on the right side. His head, voice and legs were unaffected. The tremor was worse when he was physically tired (e.g., after heavy lifting) or nervous (e.g., public speaking). Over the years, the tremor has worsened slightly and has become a source of embarrassment to him.On examination, the patient showed no distress and had normal vital signs; he was alert, behaved appropriately and had age-appropriate speech and language. Results of a cranial nerve examination were normal. A motor system examination showed normal bulk and tone. Strength in the upper and lower limbs was graded as 5 out of 5 in a manual muscle test. Results of sensory and gait examinations were normal. He was able to walk without difficulty using a tandem gait.

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Tremor in School-Aged Children: A Cross-Sectional Study of Tremor in 819 Boys and Girls in Burgos, Spain

Cited by 17 publications

References 33 publications

Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor

Prenatal exposure to the organophosphate pesticide chlorpyrifos and childhood tremor

Tremor in a Population-Based Cohort of Children in New York City

Two children with tremor

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