It can be caused by a number of underlying problems, which can either be neurological or nonneurological. Hypotonia can be defined as abnormally low muscle tone, or reduced resistance. Low muscle tone and hypotonia diagnosis and treatment, causes and symptoms, floppy baby. Therefore, hypotonia is a phenotype of many clinical conditions with variable prognosis 1. The latter, also called a neuro exam, may be performed with. Hypotonia can result from a many central or peripheral causes. Hypotonia and how to assess muscle tone with the pediatric patient. It should be noted that our study is confined to describing only those infants whose hypotonia was caused by pws so that the prevalence of neonatal hypotonia in scotland during the study period and hence the proportion of those hypotonic infants who actually had pws is unknown.
Infants with this problem seem floppy and feel like a rag doll when held. The first step in the evaluation of a child with hypotonia is localization to the central cerebral or peripheral nervous system, or both. It is defined as a subjective decrease of resistance to passive range of motion in a newborn and can be due to a defect at any level of the nervous system. If your infant has hypotonia, they may appear limp at birth and not. Hypotonia definition of hypotonia by merriamwebster. Dr peter camfield, iwk health centre, 5850 university avenue, po box 3070, halifax, nova scotia b3j 3g9. Neurological conditions are those that affect the nerves and nervous system. This condition may be seen in babies, causing less control of their limbs. These studies have discussed differential diagnosis in hypotonia of central versus peripheral origin,14 longterm prognosis for children with hypotonia, 1,11 assessment techniques, 8,11,14 characteristics of children with hypotonia, 1 and suggestions for intervention.
The present paper discusses a rational, simple and accurate diagnostic approach to hypotonia in infancy. Mar 27, 2019 hypotonia is a medical term used to describe decreased muscle tone. The term cerebral hypotonia describes a symptom complex concerning the contribution of higher cortical functions to muscle tone and motor development. Your childs muscle weakness can be caused by several different diseases, and treatment cannot begin without sussing out the real cause. The evaluation of the hypotonic infant vanderbilt university medical. Hypotonia definition is the state of having hypotonic muscle tone. Lowtoned muscles contract very slowly in response to a stimulus and cannot maintain a contraction for as long as a normal muscle. Low muscle tone, or hypotonia, is one of the physical problems often associated with developmental delays. Hypotonia is a common chief complaint listed in referrals to child neurologists in both inpatient and outpatient settings. Provide definition severely reduced muscle tone signs and symptoms general the most common symptoms involve problems with walking, posture, breathing. How boston childrens hospital approaches muscle weakness. Low muscle tone and hypotonia diagnosis and treatment our.
Outgoing teen meredith zanelotti has been able to remain active through management of her low muscle tone and underlying genetic disorder at the johns hopkins hypotonia center. Hypotonia may be the presenting sign for many systemic diseases and diseases of the nervous system. Children can have generalized hypotonia or it may affect just speci. They retain a certain amount of tension and stiffness muscle tone that can be felt as resistance to movement. Hypotonia is reduced tension or resistance of passive range of motion. Hypotonia occurs in every muscle, so any activity that requires muscles is likely to be impaired. Hypotonia related body system vision respiratory lymphatic dental hearing digestive integumentary skin endocrine cardiovascular nervous musculoskeletal genitourinary blood what is it. This consultation request usually occurs in 2 different situations. Central hypotonia may be generalized and affect the. Hypotonia is a symptom that can be caused by many different conditions.
Your childs doctor will obtain a medical history for your family and your child and will perform a physical examination that will likely include a detailed muscle function and neurological examination. In the eighth grade, however, my french teacher confessed to me that her fivemonth. Bodensteiner, md the pediatric neurologist is regularly asked to evaluate a hypotonic patient. For awhile, i thought i was the only person i knew who had it. Hypotonia, commonly known as floppy baby syndrome, is a state of low muscle tone the amount of tension or resistance to stretch in a muscle, often involving reduced muscle strength.
In healthy muscles some amount of stiffness or tension. Speech is likely to be delayed and speech therapists needed. A schematic approach to hypotonia in infancy joanna leyenaar md mph, peter camfield md frcpc, carol camfield md frcpc department of pediatrics, dalhousie university, iwk health centre, halifax, nova scotia correspondence. Low muscle tone is often associated with floppiness, limpness or a feeling of heaviness when a limb is moved by another person. Malnutrition malnutrition in the mother as well as the baby or child. Low muscle tone and hypotonia diagnosis and treatment. The condition was first described in 1956 among infants who were termed floppy infants.
Hypotonia is a common symptom of muscular dystrophy, which comes in more than 30 different types, according to kidshealth, a child development site 1 2. Hypotonia decreased muscle tone is a symptom rather than a condition. My own cousin, a naturopathic doctor, refuses to believe that i have hypotonia, because she has limited knowledge of it. Hannibal, md, phd author disclosure drs peredo and hannibal have disclosed no. Learn more about the symptoms and treatment of hypotonia with expert advice from sharecare. The learner will be able to perform an evaluation of a child with hypotonia. Hypotonia, or poor muscle tone, is usually detected at birth or during infancy.
Hypotonia is reduced resistance to passive movement of joints. Hypotonia in infants pediatrics clerkship the university. Infants with normal tone tend to have flexed elbows and knees. Central hypotonia originates from the central nervous system, while peripheral hypotonia is. They retain a certain amount of tension and stiffness muscle. Hypotonia information page national institute of neurological. Generalized neonatal hypotonia implies a pathologically decreased postural tone involving at least the extremities, trunk and neck occurring during the first month of life. Hypotonia in a newborn poses a diagnostic challenge for neonatologists and pediatricians, as it is a clinical sign suggestive of both benign and. In some cases, braces may be needed to permit a full range of movement in patients with hypotonia. Benign congenital hypotonia and its variants are medical labels which describe a condition of low muscle tone usually the same thing as weak muscles. Hypotonia is a clinical manifestation of over 500 genetic disorders. How can theratogs contribute to the management of children with hypotonia.
The present paper discusses a rational, simple and accurate diagnostic approach to hypotonia in infancy, illustrated by the case of a fivemonthold infant girl recently referred to the iwk health centre in. Congenital hypotonia is a relatively common diagnosis in the newborn period. A structured approach to the assessment of a floppy neonate ahmed. Some causes of hypotonia are a result of malnutrition, these include. This commentary does not contain a discussion of an unapproved investigative use of a commercial productdevice. May 04, 2012 hypotonia is a condition in which the patient has poor or decreased muscle tone. Patients with central hypotonia generally have hypotonia. Normally, even when relaxed, muscles have a very small amount of contraction that gives them a springy feel and provides some resistance to passive movement. However, disorders of the central nervous system may also manifest. Some children with hypotonia may have trouble feeding, if they are unable to suck or chew for long periods. They rest with their elbows and knees loosely extended. The ninds supports research on conditions that can result from neurological disorders, such as hypotonia. Sep 27, 2019 hypotonia, or poor muscle tone, is usually detected at birth or during infancy.
Cerebral hypotonia the coalition against pediatric pain. Hypotonia definition at, a free online dictionary with pronunciation, synonyms and translation. Hypotonia definition of hypotonia by the free dictionary. Hypotonia, or severely decreased muscle tone, is seen primarily in children. Muscle weakness hypotonia boston childrens hospital. Much of this research is aimed at learning more about these conditions and finding ways to prevent and treat them. Later in infancy, hypotonia may be more obvious once delayed achievement of motor milestones becomes evident, with or without accompanying delay in other areas of development. Hypotonia is a condition in which the patient has poor or decreased muscle tone. May 31, 2019 some causes of hypotonia are a result of malnutrition, these include. Some children might show symptoms of muscular dystrophy soon after birth, while it might take decades for it. Even the floppiness that you hear the professionals talk about, for example, is because the muscles, as a result of the hypotonia, are much less supportive of the skeleton, so the joints of the bones are not held together by the muscles as well as they should be.
Literature in the 1960s reflects an understanding of the cerebral influences on tone and motor control. Decreased muscle tone and strength that results in floppiness. Hypotonia definition of hypotonia by medical dictionary. For example, a person relies on the tone in their back and neck muscles to maintain their position when standing or sitting up. Hypotonia hypotension, the lowering of tone tension of a tissue, organ, or system. Objectives the learner will be able to explain the definition of hypotonia and how to assess muscle tone with the pediatric patient. In some cases, hypotonia is due to genetics, in others, its environmental factors or disorders like down syndrome and cerebral palsy. Clinical and developmental assessment identifying the underlying cause of congenital hypotonia remains difficult, despite. Cerebral or central hypotonia implies pathogenesis from abnormalities from the central nervous system, and related causal disorders include cerebral dysgenesis and genetic or metabolic disorders. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Low muscle tone and hypotonia diagnosis and treatment please note that this article on hyptonia is one of several we are putting together, our personal experience and understanding with hypotonia etc can found there. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain or muscle strength.
The deficits causing hypotonia can originate in the brain, spinal cord, peripheral nerves, neuromuscular junction, and muscle. The majority of individuals function in the mildtomoderate range of intellectual disability. The term hypotonia is most often used to denote a lowering of blood pressure below 10565 mm hg 148. At boston childrens, doctors have several tests available to. A child with hypotonia may also have problems with speech or exhibit shallow breathing. A 22year retrospective study of hypotonic neonates admitted to the neonatal intensive care unit was conducted. Central hypotonia is more likely to be noted axially with normal strength and hyperactive to normal deep tendon reflexes. Clinical confirmation of hypotonia once the suspicion of hypotonia has been raised, the evaluation of the floppy infant should proceed by searching for those clinical. Treating hypotonia 01012009 outgoing teen meredith zanelotti has been able to remain active through management of her low muscle tone and underlying genetic disorder at the johns hopkins hypotonia center. The elements of the clinical evaluation of the hypotonic child including those. Specific etiologies of central hypotonia include brain insults and malformations, as well as genetic, metabolic, traumatic, anatomical, or idiopathic causes of central neural dysfunction.
Jun 05, 2019 hypotonia literally means loss of muscle tone. Hypotonia, commonly known as floppy baby syndrome, is a state of low muscle tone often. Untreated hypotonia can lead to hip dislocation and other problems. Request pdf the evaluation of the hypotonic infant the pediatric neurologist is regularly asked to evaluate a hypotonic patient. I will try to outline the factors related to the production of muscle tone in infants and children.
Infants have feeding difficulties, failure to thrive, hypotonia, hyporeflexia, prolonged napping or need to be awakened for feeds, and generalized lethargy. The learner will be able to differentiate the common causes of hypotonia in the pediatric patient. Read about the causes of hypotonia, which can be neurological, such as cerebral palsy and muscular dystrophy, or nonneurological, such as congenital. The present paper discusses a rational, simple and accurate diagnostic approach to hypotonia in infancy, illustrated by the case of a fivemonthold infant girl recently referred to the iwk health centre in halifax, nova scotia. The evaluation of the hypotonic infant request pdf researchgate.
Neonatal hypotonia, also known as floppy infant syndrome, is the main presenting clinical feature of most neuromuscular diseases of early life 1. Hypotonia is quite devastating even though it can almost be invisble to a parent. A discussion of an important neuromuscular disease, diagnosed in the present patient, concludes the paper. Hypotonic infants rest with their elbows and knees loosely extended, while infants with normal tone tend to have flexed elbows and knees. With hypotonia, the brain fails to transmit the proper electrical signals to the muscles that tell them to contract. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain.
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