Red flags & when to go in person for Tremor in Children

Audience: pediatric

Tremors in children are involuntary shaking movements that can have many causes. While some tremors are harmless and can be monitored through telemedicine, others may indicate serious health issues requiring in-person evaluation. Telemedicine can help assess symptoms, review medical history, and guide families on next steps. However, if a child experiences sudden or worsening tremors, weakness, difficulty walking, or other concerning signs, prompt in-person care is important. This guide helps families understand when telemedicine is suitable and when to seek urgent medical attention for a child with tremor.

Red flags — go in person / ER

• Sudden onset of tremor with weakness or difficulty walking — seek emergency care immediately.
• Tremors accompanied by changes in speech, vision, or consciousness — go to the nearest emergency department.
• Tremors with fever or rapid worsening — prompt in-person evaluation is necessary.

What telemedicine can do

• Initial assessment of tremor characteristics and history.
• Monitoring mild, stable tremors without other concerning symptoms.
• Providing guidance on symptom management and follow-up plans.

What telemedicine cannot do

• Emergency situations with sudden weakness or altered consciousness.
• Severe or rapidly worsening tremors needing urgent neurological evaluation.
• Performing physical exams or diagnostic tests requiring specialized equipment.

What is a Tremor?

A tremor is an involuntary, rhythmic shaking of a part of the body. In children, tremors can affect the hands, arms, head, or other areas. They may happen when the child is at rest or during movement. Tremors can be caused by many factors, including fatigue, anxiety, medications, or underlying neurological conditions.

When Telemedicine Can Help

Telemedicine visits can help healthcare providers understand your child's symptoms by asking detailed questions and observing the tremor through video. This can often help identify if the tremor is mild or if there are other signs needing further evaluation. Telehealth can be a convenient first step to discuss your concerns and plan care.

Red Flags That Need In-Person Care

Certain signs with tremors in children require urgent in-person evaluation. These include:

If you notice these, seek emergency or urgent medical care immediately.

Preparing for a Telemedicine Visit

To get the most from a telemedicine visit:

After the Telemedicine Visit

After your telemedicine appointment, you may be advised to:

Always keep emergency numbers handy in case urgent care is needed.

How to prepare for your tele-visit

• Ensure a stable internet connection and a quiet, well-lit room.
• Have a family member assist with showing the tremor on camera.
• Prepare a timeline of when the tremor started and any changes.
• List all current medications and any recent illnesses or injuries.
• Note any other symptoms such as weakness, balance issues, or changes in speech.

After your tele-visit

• Follow the healthcare provider's instructions regarding symptom monitoring.
• Schedule in-person visits or tests if recommended.
• Keep a symptom diary to track any changes.
• Contact your provider if new or worsening symptoms occur.
• Seek emergency care immediately if red flag signs develop.

FAQs

Can telemedicine diagnose the cause of my child's tremor?

Telemedicine can help gather important information and observe the tremor, but it often cannot provide a definitive diagnosis without physical exams or tests. In-person evaluation may be needed for diagnosis.

When should I take my child to the emergency room for tremors?

If your child has sudden tremors with weakness, difficulty walking, changes in speech or consciousness, or fever with worsening symptoms, go to the emergency room immediately.

Are all tremors in children serious?

No, many tremors are harmless and related to fatigue, anxiety, or temporary causes. However, some tremors may signal underlying health issues, so monitoring and assessment are important.

How can I help my child during a telemedicine visit?

Help by showing the tremor clearly on camera, providing detailed history, and answering questions honestly. Prepare your child's medication list and symptom timeline beforehand.

What treatments are available for tremors in children?

Treatment depends on the cause. Some tremors may not need treatment, while others may require medication, therapy, or further evaluation by specialists.

Sources

1. Tremor in Children — MedlinePlus, U.S. National Library of Medicine.
2. Overview of Tremor — Mayo Clinic.
3. Movement Disorders in Children — National Library of Medicine.
4. When to Seek Emergency Care for Neurological Symptoms — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical evaluation and care. If your child has severe or worsening symptoms, seek immediate medical attention.