1. A 6-month-old boy is brought to the pediatrician's office with recurrent episodes (multiple times a day) of staring and rapid tremors/shivering of the head, shoulders, and trunk, sometimes leaning to one side while sitting. The spells typically occur when he is getting ready to eat or during a bath. The episodes have a quick onset and offset, and it appears that he is aware during the episodes. Otherwise, he has been growing well and meeting age-appropriate milestones. He had an uneventful antenatal and perinatal course, and his physical examination is unremarkable. Based on this information, what is the most likely diagnosis?
You asked the family to provide videos, which you reviewed, and you are suspicious of shuddering attacks. What options below seems reasonable for the evaluation and management of a child with shuddering attacks, as well as considerations for long-term prognosis?
