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Uncontrollable shaking, increased heartbeat, not cold. Child has ADD and autism. What could this be?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
My 11 year old son has ADD/ODD and recently his bio medical DR. tends to think he has a small percentage of high functioning autism as well. He recently started shaking uncontrollably at night when he first lays down at bed time. It only happens a couple times a week for the last 3 weeks. He is not on ADHD prescription meds. We have tried several different kinds before since he was 9 years old, and he has way too many side effects -weight loss, dark circles under eyes, pale, rapid heart rate, moody, would not sleep, would not eat or drink properly, sickly looking. So I decided to keep him off the stimulants. He does take enzymes, probiotics, and recently added Hyland's Calms (nerve tension, sleeplessness) in the evening in replacement of L-Theanine- as suggested from his biomedical DR. He was on the Feingold diet to look for food sensitivities. He is sensitive to peaches, food dyes, and some food preservatives. Since starting the Feingold diet in the fall, and tapering off of it once we found out his sensitivities, I pack his school lunch and try to feed him breakfast at home when he will take the time to eat. The past few week's he has been eating more school food despite me packing his school lunches. ... He often says his brain does not stop thinking. He is generally a highly anxious child, and often tends to have anger issues when he does not get his way or if he is stressed about something, or does not understand something. However, he was calm tonight when he went to bed. He went to bed on time at 8:30pm) Less than 10 minutes later he came out of his room saying he started shaking uncontrollably again and it scared him. I asked if he had a bad dream or was thinking of something that scared him, he said no. He said his heart started to beat really fast and was shaking like he was cold, but he was not cold. He was clearly scared and started to cry in a panic. I let him get his blankets and lay in the same room as me and he went to sleep within minutes. What could this be? Is this normal? What should I do? I do not know what else to ask, if is frightening. Of course, as a concerned parent, I worry.
Posted Fri, 20 Apr 2012 in Child Health
Answered by Dr. Hema Yadav 3 hours later

Thanks for posting your query.

I understand your concern as a worried parent and appreciate your vigilance and care towards your child.

The symptoms you mentioned are not usually normal and may indicate underlying problems like psychological disturbance (anxiety, ADHD – Attention Deficit Hyperactive Disorder) or a seizure disorder.

To differentiate please note that the following points point more in favor of a convulsion and you need to go for further evaluation and investigation if your child has them.

1. Involuntary generalized shaking of body associated with loss of consciousness
2 up rolling of eyeballs
3 tongue bite or teeth grinding or fist clenching
4 vomiting
5 involuntary passing of stools/urine
6 no response to commands or disorientation.

If what your child has is just shaking but fully conscious, oriented, none of the above features then the cause could be the hormonal imbalance caused by anxiety, ADHD/ODD (Oppositional Defiant Disorder) .Sometimes children with ADHD can develop seizure disorder in adolescence. So, it’s better to get him investigated by consulting a neurologist and if needed, getting an EEG (Electroencephalography) done.

This might come normal but it will allay your fears and anxiety and prevent any misdiagnosis.

Meanwhile you should maintain a dairy of such events for further reference to your treating doctor as mentioning the onset duration progress and resolution of such attack. It can help in confirming the diagnosis and accordingly further management.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

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