Toddler Tremors and Weakness: When to Seek Help

The child exhibits weakness in the legs and occasional tremors in the hands?

Hello, I would like to ask about my child who is one year and three months old.
Since he was five or six months old, I have noticed that his hands occasionally tremble, usually one hand at a time.
Each time we have a pediatric check-up, the doctor says it is normal for infants who have not yet developed control over their hand muscles and that it will improve as he grows older.
However, this phenomenon has persisted.
Recently, after receiving a vaccination at one year and three months, I asked the doctor again, and he mentioned that the trembling could be due to unstable blood sugar levels in infants (the doctor suggested that changing his diet would help).
How can we improve this situation?
Additionally, my child only dares to stand while holding onto something, but I have noticed that his legs suddenly become weak and he falls down.
He is also hesitant to let go.
His walking posture seems unusual, with an outward toeing appearance.
It seems that he struggles to stand up compared to other children, needing to exert a lot of effort with his hands to pull himself up.
We consulted an orthopedic specialist and had X-rays taken of his wide joints, which showed no abnormalities.
The doctor suggested that he might have some ligament laxity.
How much longer should we wait to see if the situation improves, and what kind of further examinations should we consider if it does not? Which pediatric specialty clinic should we visit? Is there a hospital in Tainan that specializes in this type of condition?

vivian, 30~39 year old female. Ask Date: 2008/03/24

Dr. Xiao Kaiwen reply Pediatrics

At one year and three months old, the child can only stand while holding onto objects and cannot stand for long periods.
They require significant strength in their hands to pull themselves up, which indicates abnormal motor development.
It is important to assess whether there are issues with brain control development or muscle function.
It is recommended to consult a pediatric neurologist at a medical center (in Tainan, you should go to Cheng Kung University Hospital).

Reply Date: 2008/03/24

More Info

When it comes to understanding toddler tremors and weakness, it is essential to approach the situation with a comprehensive perspective. Your concerns about your child's hand tremors and difficulty standing are valid, and it is crucial to seek appropriate medical advice and intervention.

Tremors in toddlers can be attributed to various factors, including developmental stages, muscle control, and even temporary conditions like low blood sugar. As you mentioned, pediatricians often reassure parents that these tremors are common in young children who are still developing motor skills. However, if these tremors persist beyond the typical developmental timeline, it may warrant further investigation.

In your case, the tremors have been ongoing since your child was five or six months old. While some degree of tremor can be normal, especially in infants, persistent tremors that do not improve with age should be evaluated more thoroughly. The suggestion from the doctor that the tremors could be related to blood sugar levels is worth considering, especially if your child has irregular eating patterns. Ensuring that your child has a balanced diet with regular meals can help stabilize blood sugar levels, which may, in turn, reduce tremors.

Regarding your child's difficulty standing and the observation of "external rotation" (often referred to as "out-toeing"), this could be linked to several factors, including muscle strength, coordination, and possibly ligament laxity. The fact that your child requires significant support to stand and has difficulty getting up could indicate a need for further evaluation. While the orthopedic assessment showed no abnormalities in the hip joints, it might be beneficial to explore other areas, such as neuromuscular function or developmental delays.

If your child continues to struggle with these issues, I recommend seeking a referral to a pediatric neurologist or a pediatric rehabilitation specialist. These professionals can conduct a more in-depth assessment of your child's motor skills, muscle tone, and overall development. They may also recommend physical therapy to help strengthen your child's muscles and improve coordination.

In terms of finding specialized care in Tainan, you might want to look for hospitals or clinics that have a pediatric neurology department or a pediatric rehabilitation unit. Institutions affiliated with universities often have specialized pediatric services and can provide comprehensive evaluations and treatment plans.

In summary, while some degree of tremors and weakness can be typical in toddlers, persistent symptoms that interfere with daily activities should be evaluated by a specialist. Early intervention can significantly impact your child's development and quality of life. It is essential to advocate for your child's health and seek the necessary evaluations to ensure they receive the appropriate care and support.

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