Question Title: 3 year old trembles & complains of cold & soreness

My three year old son's hand & wrist trembles when he raises an eating
utensil, drinking glass, toothbrush, etc. to his mouth. It appears to be
primarily his right (dominant) hand that trembles, but we've also noticed
that sometimes his lower jaw shakes too. (Our pediatrician has
witnessed the trembling.) It's been going on for about a year.
He doesn't eat/drink caffeine and gets few sweets. He frequently complains
about being cold. Almost daily he tells us that his legs hurt. His eyes
are extremely sensitive to light. He appears to have allergies -- runny
nose all the time. Very finicky eater. Wakes up crabby most mornings.
Has always had trouble sleeping at night (nightmares and sleep walking
now). He doesn't receive OTC meds (with occasional exception of Tylenol
or Benedryl). Our pediatrician is in the process of lab tests for hyper
and hypothyroidism, and she said that if these tests don't show anything
she'll send us to peds neurologist. What will they do? (Our pediatrician
said they'd probably do an MRI or CT to look for tumors but couldn't offer
any other suggestions because she hadn't seen these symptoms in a child
before.) I'm really starting to worry! What could this be?
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Hello Robin,

The presence of a tremor in the right arm and jaw that worsens when the hand approaches a target of action like the mouth or something your child is trying to pick up suggests at least the possibility of a neurological problem involving the part of the brain that helps control movements (the basal ganglia) or coordination (the cerebellum). Its very focal nature may suggest a very unusual problem like a childhood type of a Parkinson's disease-like condition, or alternatively could represent some sort of (presumably very slowly growing if he's had the problem for over a year) tumor or other lesion in the brain. As far as the legs go and crabbiness, it's hard to say, since these are not terribly helpful or specific symptoms. A prompt and thorough evaluation by a pediatric neurologist would probably be an excellent idea, since s/he could examine your son thoroughly to look for other clues that might suggest a specific condition or problem and to differentiate it from a more benign process. The other reason to get him evaluated quickly is for your own peace of mind, so you either know what exactly it is you are dealing with if it is a neurological problem, or can be more convincingly assured if it is not. We do have a small department of pediatric neurology at the Cleveland Clinic, but I think that as an initial evaluation any pediatric neurologist should be able to get things off to a good start and most likely figure out what is going on. I would encourage you to be certain, however, that it is a true pediatric neurologist that sees your son, as opposed to an adult neurologist who also happens to see children, particularly given his young age. Please remember that the information we provide on the forum is intended strictly for general medical informational purposes only, and that the actual diagnosis and treatment of your son's specific medical condition should remain strictly in conjunction with his current treating physician(s). We hope you find the response helpful and wish you well in getting this matter resolved.

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