Sudden Shoulder Jerks in a Three-Year-Old Child

Q: Sudden Shoulder Jerks in a Three-Year-Old Child

Hello： Based on your description, it is possible that you are experiencing myoclonus. <br>The localization and causes of myoclonus are diverse; if it is limited to the shoulders, it may be related to cervical spine issues. <br>A definitive diagnosis requires further examination,

A three-year-old child suddenly experiences involuntary shoulder jerking?

Dear Dr.
Huang,
Thank you for taking the time to respond despite your busy schedule.
I am currently abroad and would greatly appreciate your advice.
My three-year-old child has suddenly developed involuntary and repetitive shoulder jerks, affecting both shoulders.
The frequency is not consistent, and each episode can last over five seconds with significant force.
I have pressed down on their shoulders, but I can still strongly feel the jerking.
The involuntary movements are limited to the shoulders (not shrugging), and the rest of the body and limbs appear normal.
Their gaze, mental state, and emotions are all normal, and they do not scream or make any sounds.
The child reports no pain and is unaware of why their shoulders are moving on their own.
This symptom has never occurred before and has persisted for three days.
They have not taken any medication recently, and there have been no changes in diet or routine.
There has been no head trauma; the only recent issue has been mild cold symptoms (runny nose and slight cough).

Could you please inform me of the possible causes of this condition? Should I urgently return to Taiwan for medical attention? Thank you very much for your kindness and assistance.
Sincerely,
A worried and sleepless mother

Xinji Ruwen de Mama, 0~9 year old female. Ask Date: 2016/07/02

Dr. Huang Yingzhe reply Neurology

Hello: Based on your description, it is possible that you are experiencing myoclonus.
The localization and causes of myoclonus are diverse; if it is limited to the shoulders, it may be related to cervical spine issues.
A definitive diagnosis requires further examination, as more serious causes such as tumors or arteriovenous malformations could be involved.
I recommend consulting a pediatric neurologist for evaluation.

Reply Date: 2016/07/02

More Info

Understanding sudden shoulder jerks in a three-year-old child can be quite concerning for parents, especially when the child exhibits involuntary movements that are not typical for their age. In your case, the child is experiencing repeated jerking movements in both shoulders, which last for several seconds and are strong enough to be felt even when pressure is applied to the shoulders. Importantly, the child does not appear to be in pain, and other physical and cognitive functions seem normal.
These involuntary movements could potentially be classified as myoclonus, which refers to sudden, brief, and involuntary muscle jerks. Myoclonus can occur for a variety of reasons, including physiological causes (like sleep myoclonus), neurological disorders, or even as a reaction to certain medications or metabolic imbalances. In children, myoclonic jerks can sometimes be benign, especially if they are isolated and do not interfere with the child's daily activities or development.

Given that the child has no history of similar symptoms, no recent head trauma, and is otherwise healthy, it is essential to consider a few factors:
1. Duration and Frequency: Since the jerking has persisted for three days, it is important to monitor the frequency and intensity of these movements. If they increase in severity or frequency, it may warrant further investigation.

2. Associated Symptoms: While the child currently does not exhibit pain or other concerning symptoms, it is crucial to remain vigilant for any new developments. Symptoms such as changes in consciousness, weakness in limbs, or any signs of distress should prompt immediate medical attention.

3. Possible Triggers: Consider any recent changes in the child's environment, diet, or routine that could contribute to these movements. Stress, fatigue, or even minor illnesses can sometimes provoke unusual muscle activity in children.

4. Consultation with a Specialist: Given the nature of the symptoms and the fact that they are new, it would be prudent to consult a pediatric neurologist. They can perform a thorough evaluation, which may include a physical examination, neurological assessment, and possibly imaging studies or electroencephalography (EEG) to rule out any underlying neurological conditions.

5. Emergency Care: If at any point the child experiences additional concerning symptoms, such as seizures, loss of consciousness, or significant changes in behavior, it would be advisable to seek emergency medical care immediately.

In summary, while the current symptoms may not indicate an immediate emergency, they do warrant careful observation and professional evaluation. It is always better to err on the side of caution when it comes to a child's health. If you feel uncertain or anxious about the situation, do not hesitate to reach out to a healthcare provider for guidance. Your child's well-being is paramount, and seeking expert advice can provide peace of mind and ensure that any potential issues are addressed promptly.

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