Tremors, Hand Shaking, and Tics in Children

If your child sometimes has shaking hands during everyday activities or makes repetitive motions or sounds, it could be a sign of a tremor or tic.

These are sometimes associated with serious medical conditions, but they're often not. That's especially true if your child is otherwise healthy, growing, and developing normally.

This article looks at what causes tremors and tics in children, when you should be concerned, and how they're diagnosed and treated.

Male nurse talking to boy in examination room
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Tremors in Children

Tremors are rhythmic shaking movements that most often happen in the hands, but can also occur in the arms, legs, head, vocal cords, and torso. Tremors can occur while a child is resting or active.

Children can have an essential tremor, which is shaking with an unknown cause. A condition called familial tremor is an essential tremor that affects more than one family member.​ About 50% of the cases of essential tremor are thought to be caused by a genetic risk factor.

Researchers estimate that up to 5% of people have essential tremor. One study found they often start in kids as young as 8 years old.

Tics in Children

Tremors are different from tics. These are sudden, uncontrollable twitches, movements, or sounds that may be repetitive. Children commonly have tics.

Many parents worry a tic means their child has a serious condition like Tourette's syndrome. But they're much more likely common to have a simple transient (passing) tic disorder.

Children with a transient tic disorder may repeatedly:

  • Make sudden, brief jerky movements of their arms
  • Blink their eyes
  • Raise their eyebrows
  • Shrug their shoulders
  • Bite their lip
  • Turn their head

In addition to these types of involuntary motor tics, other children may clear their throat or make specific sounds (vocal tics). These tics are often so subtle that other people don't notice them.

As the name suggests, transient tics only last a short time. Typically, that's about three months or less.

If tics last much longer than three months or become more complex, ask your healthcare provider about Tourette's syndrome.

Tics + OCD?

If tics and obsessive-compulsive disorder (OCD) symptoms start suddenly or get worse after a strep throat infection, tell your healthcare provider. It could be a sign of pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections (PANDAS).

Causes of Tremors in Children

Some tremors are caused by serious illnesses. Those tremors usually come along with other symptoms. Tremors can occur at any age and be due to several possible causes, including:

  • Anxiety or stress
  • Hunger
  • Caffeine
  • Genetics
  • Damage to brain structures that control muscle activity
  • Head injury (children who lose consciousness are at a greater risk for developing tremors)
  • Liver failure
  • Multiple sclerosis
  • Metabolic disorders, like hyperthyroidism (overactive thyroid)
  • Side effect of some medications
  • Stroke

Occasionally teenagers can develop shaking hands too. If you notice this, your teenager's healthcare provider should do a full physical examination and blood tests to check for:

Causes of Tics in Children

Transient tics can happen randomly and may be associated with:

  • Stress
  • Anxiety
  • Tiredness
  • Excitement
  • Happiness

They often start with an unpleasant sensation that builds up in the body until relieved by the tic – known as an urge.

The cause of more complex tics is not known but is thought to be a disorder associated with neurotransmitters in the brain and is frequently present in multiple family members, indicating a genetic component for them. 

Diagnosis and Treatment

A new or worsening tremor or tic are reasons to take your child to a healthcare provider. A physical examination that includes a neurological exam can help figure out what's behind the unusual movements.

Some children with persistent tremors and tics see a pediatric neurologist. However, most children with transient tics and essential or familial tremors don't need any kind of treatment.

A Word From Verywell

Pattern recognition is key in most medical conditions, so if a tremor is new, worsening over time, or associated with additional symptoms, it's best to talk it over with your healthcare provider. Rest assured, most tremors and tics in children won't require any long-term treatment.

Treatment for Tremors

Physical therapy and learning new ways to perform tasks can help reduce tremors in children. Sometimes foods aggravate tremors, so you may need to watch for patterns and then avoid any triggers you discover. Relaxation therapy to reduce stress can also help. If necessary, certain medications can reduce symptoms. These include anticonvulsants and beta-blockers (drugs for high blood pressure). 

Treatment for Tics

Tics can be treated with self-help tips, such as limiting situations that cause stress, anxiety, boredom, and fatigue. Several types of psychotherapy might also be recommended, such as:

  • Habit reversal therapy
  • Comprehensive behavioral intervention for tics (CBiT)
  • Exposure and response prevention (ERP)

Medications may also be used to reduce tics and treat associated medical conditions. These medications can have side effects, so it's important to discuss the pros and cons with your child's health care provider.

Summary

Tremors and tics in children are usually not associated with serious medical conditions. Essential tremor and familial tremor are both possible and don't involve illness or other symptoms.

Some medications can cause tremors, as well. When tremors are caused by serious conditions, they're usually accompanied by other symptoms.

Tics raise concerns about Tourette's syndrome. But it's more likely your child has a transient tic disorder that'll go away in three months or less.

If your child has a new or worsening tremor or tic, it is accompanied by other symptoms, or they last for more than a few months, see their healthcare provider.

Most kids with tremors and tics don't need treatment. For those who do, beta-blockers may be prescribed for tremors and self-help tips, therapy, or medications can help reduce tics.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Vincent Iannelli, MD
 Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.