7 year old with arm tremors

[Fatherofthree]

     As my name suggests (Fatherofthree) I am the father of three children. My oldest is 7 and for the past couple of weeks we have noticed slight tremors in both arms. I don't know if they classify as "tics" or "tremors" but it looks as if the whole arm or (possibly) the bicep tenses occasionally and causes his arms to "jump". It doesn't happen in his sleep and he seems to be able to stop it when we ask if he can. It is a bit hard to say though, because when I hold his arm to see if I can feel what is happening he will tense and release on purpose until I tell him to stop. But when he is watching TV or reading a book and is not aware that I am watching, I can see the tendon in the inner elbow tense every few seconds causing his arm and hands to shake jump slightly. Its not bad enough to cause him to drop things or spill drinks, etc but it is noticeable if you are watching and expecting it to happen.
     To make things a bit more complicated he saw a pediatric neurologist a year and a half ago on the advice of an OT because he has some slight weakness in his hands that causes his handwriting to be a sloppy. The PN said that he seemed fine and that the weakness was simply due to delayed development and underdactivity involving hand strength tasks.
     Now we are being asked by his pediatrician to take him to see a PN again. We are - but getting an appointment soon is proving to be a bit difficult. In the meantime I am not dealing well with the worry. Can a PN on this forum give me some feedback? Are both arms "jumping" slightly every few seconds a sign of anything in particular? Is it a common "phase" for children to experience in their development? He also does this thing where he wrinkles his nose and widens his eyes on occasion but we always thought that was likely a nervous "tic" that he would outgrow (common on both sides of the family for young boys). Is that possibly related? Any feedback that helps me understand what I am seeing would be greatly appreciated.
     Thanks.

[Fatherofthree]

     To further update the situation ... I noticed that my son's arm "twitches" also happen while he is sleeping but only very infrequently and more likely if he is moved (so we can see if his arms are twitching). But then today the problem seems less noticeable (maybe I'm being optomistic) and I have observed him doing a number of things that invlolve fine motor skills without the movements causing him any difficulty. He doesn't have any pain and he has not complained that it is even bothering him. He will likely be able to see a PN this coming week and until then I really want to believe that this could actually be the temporary, benign form of motor tics that nearly 20% of all children experience at some point (information taken from online articles). Could it still be motor tics if it happens infrequently while sleeping? He can stop it for a short while if you ask him to... I'm just praying that is a good sign.

[Fatherofthree]

Thank you for the feedback. If they are motor tics I will be very happy to hear that. Motor tics (from what I have read) seem to be failry common in boys his age and generally clear up over a few weeks or months. At the worst they could be a sign of TS which would be much better news than some sort of degeneravtive nerve disorder. I am no doctor and can only go by what I have read but since he has not weakened noticeably and the tics or "tremors" are slight and (seem to be) controllable that should point to something relatively minor. I could be wrong but that seems to be the case from what I have observed and referenced against available information.
Again thank you for replying ... any other MDs out there who want to contribute I would be happy to hear your opinions.

[Abhijeet Deshmukh, MD]

Hello.

I am not a pediatric neurologist, but I can mention here that your son probably has motor tics. This is helped by the fact that he can control them for some time, and they are absent in sleep.

I am sure thing will be clearer when you visit the PN.

Regards