Cranial Neuroimaging in Infantile Tremor Syndrome: The Road Ahead SC01-SC04
Dr. Rajesh Gupta,
C-204, Chirayu Medical College Campus, Bhopal-Indore Highway, Near Bairagarh, Bhopal-462030, Madhya Pradesh, India.
Introduction: Infantile Tremor Syndrome (ITS) is a self-limiting clinical state of unknown aetiology characterised by tremors, anaemia, pigmentary skin disease, regression of mental development and hypotonia of muscles in a plump looking child, mostly reported from Indian subcontinent.
Aim: To analyse the role of cranial neuroimaging in identifying aetiology of ITS patients.
Materials and Methods: This observational cross-sectional study done at Department of Paediatrics, RD Gardi Medical College, Ujjain, Madhya Pradesh, India, was conducted during the period of April 2013 to August 2014. Ten patients admitted with clinically diagnosed ITS were studied. Patient profiles, history, anthropometric measurements, general and systemic examination along with cranial neuroimaging were also studied.
Results: Out of ten ITS patients, four were males and six females. Mothers of all children were vegetarian and Hindu by religion. Severe wasting was present in four patients whereas three had moderate wasting. On cranial neuroimaging non specific cerebral atrophy of different grades was observed in all cases except one and cerebellar atrophy in one case of ITS. Reduced thickness of corpus callosum was observed in six patients and nine children had prominence of Sylvian sulcus. Out of the four children with severe wasting three had evidence of cerebral atrophy; moreover, all the three patients having moderate wasting had evidence of cerebral atrophy.
Conclusion: Different grades of cerebral atrophy, ventricular enhancement along with corpus callosum thinning have been the key findings in ITS patients. Findings support nutritional deficiencies as most probable aetiology.