Shuddering Spells

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This blog was originally posted on The Pediatric Insider © 2012 Roy Benaroch, MD

A parent asks: “My 11-month-old daughter was seen for odd shaking of her torso and head at weird times. They said it was a shuddering attack. What is that? Do I need to worry?”

Babies sometimes move in mysterious ways. They wiggle and squirm and sometimes bits of them tremble or flail about—and it can be worrying, sometimes, when your baby moves oddly. Often, the movements really aren’t anything with a specific name or diagnosis. They might be, as a ped neurologist once told me, “CBS.” He had a bit of a potty mouth, so I’ll let you figure out what those letters mean.* Needless to say, as a young resident I cringed when he used that term in front of parents.

Shuddering attacks (sometimes called “shuddering spells”) are one very specific, normal example of a weird baby movement that’s normal and means nothing. They’re not super-common, but they’re not super-uncommon either. I see at least a few kids with this each year.

Shuddering attacks usually happen in babies and young children. They’ll suddenly bend their necks or trunks, and have a shiver-like movement—almost as if they’re having a chill. The body may briefly stiffen. During the event, the child is completely conscious and interactive (though sometimes with babies this is hard to confirm). The episode usually lasts about 5 seconds, and afterwards the child is completely fine.

Though shuddering itself is completely normal and benign, it can be concerning to parents when it’s not clear what’s going on. In some ways, a shudder can seem like a very brief seizure, but there are some big differences. Shudders, unlike seizures, never happen during sleep. After most seizures, a child experiences a period of sleepiness. And shudders themselves have such a characteristic movement that once they’re seen, they can be easy to recognize.

Sometimes, I’ve asked parents of children who may be having shudders (or other weird movements) to try to capture the event on a video. In fact, there are several examples posted on YouTube.

The diagnosis of shuddering attacks is usually made based on the history, along with an otherwise normal exam. If a pediatrician isn’t sure, a neurology referral can sometimes be helpful. Once the diagnosis is confirmed, no further testing or treatment is needed. These sorts of shudders usually stop within a few years, though even adults might occasionally feel a tingle down their spines once in a while.

*Hint: The first two letters stand for “crazy baby.”