Jitteriness refers to tremors in newborns. It is the representation of an exaggerated startle response. Tremulousness is often confused for seizures (also known as convulsion and fits), which naturally unnerves the parents.
It is the most common involuntary movement seen in infants, which disappears completely as they mature. The neuro-development of the babies with No other overt neurological sign but tremulousness is generally good, especially when their is no history of complications during pregnancy, or immediately before and after birth.
Even harmless jitteriness of infancy can sometime go into clonus.
What is clonus?
Clonus is an involuntary muscular contraction alternated by relaxation in rapid succession.
Commonly seen as coarse tremulous movements of wrist, ankle or jaw.
They are common and less significant in newborn infants than at any other age.
Clonus that is accepted within normal limits for newborns tend to occur only when an infant is active.
Is medical consultation indicated for tremulousness?
Persistent and/or exaggerated jitteriness demands professional evaluation. Sometimes it could be the manifestation of a variety of neonatal problems:
Hypoglycemia; low blood sugar levels.
Hypocalcemia; low calcium levels.
Hypomagnesaemia; low magnesium level in the blood.
Sepsis; severe infection in baby.
Drug withdrawal due to drug used by the mother. Selective serotonin reuptake inhibitors (SSRIs) prescribed for depression during pregnancy can lead to heightened startle response, tremulousness, irritability, sleep disturbances, nasal congestion and rapid breathing in the newborn baby.
Perinatal asphyxia; childbirth process related compromised oxygen levels in the newborn.
Seizures are recurrent sudden abnormal involuntary movements, commonly known as fits or convulsions. There are some distinct differences between neonatal seizures and jitteriness, which are tabulated below.
Drugs in mother can have effect on her baby at the time of birth:
a.) Drug withdrawal from baby due to maternal drug use of narcotic or barbiturates.
b.) Drug toxicity; lidocaine or penicillin administered to the mother during child birth.
Acute metabolic disorders in newborn:
a.) Hypocalcemia; lo blood levels of calcium in the body.
b.) Low blood sugar in baby secondary to diabetes in the motherc.
c.) Hypomagnesemia; low blood levels of magnesium in the body.
d.) Hyponatremia; low blood level of sodium in the body.
e.) Hypernatremia; high blood levels of sodium in the body.
f.) Hyperthyroidismg.) Hypoparathyroidism
Inborn errors of metabolism, like Galactosemia
Infections; Neonatal meningitis
What are spasms?
Spasms are sudden generalized jerks lasting 1-2 sec.
They resemble generalized tonic seizures.
Spasms last only for a very short period; less than 2 seconds.
Short span of spasms distinguish them from the generalized convulsions.
Twitching in newborns
Causes of twitching
Newborns sleep Almost 60 percent of newborns sleep is REM sleep; the light sleep. REM sleep is prone to dreams; and babies dream just as we adults do. This can sometimes cause twitching of different groups of muscles; often mistaken for migratory type of convulsion. Also happens to adults: Noted or felt as twitching during sleep or even sudden gross jerky movements (as missed a step or being pushed).
Part of moros reflex during sleep may be seen as twitching.
Recommended causes for medical consultation for twitching
Each episode of twitching lasts for more than 20 seconds.
Baby’s colour changes from tender pink to pale or bluish during the episodes of twitching, best appreciated on the lips, fingers and toes.