An old adage has it that "not all that wheezes is asthma." Similarly, not all "spells" in children are seizures. In this issue, Drs Holmes and Russman1 report on children with another nonseizure state, shuddering attacks, so named because of the shiveringlike movements made by children during the brief spells. The episodes occur spontaneously, often multiple times per day. They share many characteristics of seizurelike phenomena, including abrupt onset, stiffening of the arms, repetitive motor movements, and a positive family history of epilepsy. However, there is no alteration of consciousness and no postictal lethargy. Simultaneous electroencephalographic (EEG) telemetry and videotape monitoring show no concomitant epileptiform abnormalities during the episodes. The authors postulate that shuddering spells are benign, do not represent a form of epilepsy, and do not require anticonvulsant therapy. Our experience with several recent patients with shuddering spells seen in the Pediatric Neurology Clinic at the Arizona Health
FERRY PC. 'Shuddering Spells': Seizures or Not? Am J Dis Child. 1986;140(1):19. doi:10.1001/archpedi.1986.02140150021022
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