- Shuddering episodes are characterized by periods of rapid tremor of the head, shoulders, and arms that resemble shivering. It is often accompanied by facial grimacing with preserved consciousness
- Onset is in infancy or early childhood, but can occur as late as 10 years of age
- The episodes last several seconds and can occur up to 100 times a day.
- Spells are often triggered by excitement, frustration, embarrassment, or surprise
- The differential diagnosis of shuddering attacks includes benign neonatal sleep myoclonus, jitteriness, epilepsy, benign myoclonus of infancy, and tremor.
- The preservation of consciousness, predictable triggers, ability to abort an episode when distracted by a parent, and normal EEG distinguish this entity from seizures.
- The prognosis for development and neurologic function is uniformly good.
- Treatment is generally not needed.
Read classification of ” Paroxysmal Non Epileptic Events PNEE“