Tremor in a population-based cohort of children in New York City

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 A total of 317 children (age 11.0 ± 1.1 years; range, 9.0 to 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 nondominant 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.