Infantile Tremor Syndrome With Movement Disorder: Current Perspective

Although infantile tremor syndrome is considered a rare entity, we present a typical case of this disorder. This case reinforces the association of infantile tremor syndrome with exclusive breastfeeding in infants and the absence of proper complementary feeding. A nine-month-old, irritable, listless, exclusively breastfed female presented with grade 2 malnutrition, tremors, hyperpigmentation, scarce scalp hair, and delayed developmental milestones. Laboratory investigations revealed macrocytic anemia and a low serum vitamin B12 value of 205 pg/dL. Cerebral and mild cerebellar atrophy were noted on the MRI brain scan. Accordingly, the patient was diagnosed with infantile tremor syndrome and treated with vitamin B12 and nutrient supplementation with zinc, magnesium, folic acid, and iron. The tremors improved and the child became responsive and interested in her surroundings. It is essential to recognize this condition at the earliest and initiate treatment. Basic interventions such as the promotion of proper nutrition, timely introduction of complementary feeding, and weaning practices are key factors in decreasing the incidence of this condition.