Hypotonic Infant : Definition, Causes, Symptoms, Diagnosis and Treatment

Hypotonic Infant Definition

Hypotonia in infancy is a common sign is seen in many diseases.
 

The axial hypotonia and delay may be holding the head and then sitting, or predominate in the limbs. Hypotonia may be transient, during an acute illness of any kind, or be constant. In this case, the physician’s examination can assess the degree of hypotonia, referring to tone and motor acquisitions, holding the head, sitting, walking …, usual at the age of the child.

The assessment of muscle strength, reflexes, the type of hypotonia, axial, peripheral or global, can have an orientation to the pathology.

The course of pregnancy, occurring during the latter event, infection or trauma, may have caused brain damage, birth process, the child development from birth, the existence in family of diseases associated with hypotonia, some of which may be of genetic origin, are also important information for the diagnosis of the condition causing hypotonia.

Finally it is useful for the doctor to know if the older siblings of the child also presented hypotonia which disappeared spontaneously over time.

Depending on the direction given by clinical examination, which will usually be repeated several times at different times, a number of tests will eventually be prescribed (electromyogram, muscle biopsy, blood tests, genetic tests, MRI …)

Hypotonic Infant Causes

The hypotonia may be present in a number of general diseases, cardiac, renal, respiratory, endocrine … In this case, hypotonia is not the major symptom but one sign among others. And the diagnosis is usually made from these other signs.

Apart from these situations, hypotonia may be of central origin, that is to say in relation to a disease affecting the brain, the cerebellum or spinal cord, or peripheral origin is disease-related muscle The nerves or hypotonia of central origin constitute the majority of cases. A delay of cognitive acquisitions, that is to say, the various skills that infants acquire in the first months of life, towards a central attack. Hypotonia in an infant who has an awakening in relation to his age argues in favor of a peripheral disorder.

The causes of central involvement are numerous. It may be a malformation or a brain lesion, a genetic disease, such as trisomy 21, a metabolic disease, such as a disorder of amino acid metabolism.

Hypotonia of peripheral origin may be related to muscle disease (myopathy), motor neuron disease, the most frequent is the Werdnig Hoffman (early infantile spinal muscular atrophy), impairment of the neuromuscular junction (myasthenia) or, more rarely, a disease of the nerves (neuropathy).

When moderate hypotonia with delayed motor unimportant and without any other signs, you can give a few months to see how the child develops. If hypotonia persists or other neurological signs appear consultation with a neurologist is indicated.

Hypotonic Infant Sign

it looks like a disjointed puppet when taken, he has difficulty with sucking and chewing, it can not fully extend his members, Infant is impossible to sit or stand on its own. If hypotony is easy to see, looking for its cause is much more difficult.

Hypotonic Infant Diagnosis

For the diagnosis of hypotonia, the physician must possess all the elements that may help: course of pregnancy, childbirth, the postpartum period, etc..The history of the disease is also of paramount importance: sudden onset or gradual, is there an improvement since the contrary or an aggravation, etc..

The additional tests that can help the doctor find the cause of the disease are numerous medical tests to detect infection or a genetic cause, electromyography, CT or MRI to screen for or traumatic cause of neurological malformations. Sometimes, molecular biology allows the diagnosis of hypotonia from a simple blood test. But it takes about three months for the results. What makes the use of neuromuscular biopsy is still recommended especially when the risk to life is at stake or if there is a case of hypotonia in the family, it is possible to diagnose pregnancy in means of molecular biology. In infants, an abnormal motor development but isolated or swallowing problems orient the diagnosis towards a peripheral injury, while a macro or microcephaly and epilepsy are in favor of a central attack.

Hypotonic Infant Treatment

When the cause is known, the removal of such cause is the main treatment for hypotonia. If the bit is marked hypotonia with delayed motor little obvious, one can observe an expectant attitude. The speech and occupational therapy help a lot in improving speech and breathing and swallowing problems. Physical therapy strengthens the tone of the whole body thus improving traction.Sensory stimulation is recommended in young children and babies. Children with mild hypotonia normally pass the different stages of motor development but at a slower pace, intellectual development is normal.

When hypotonia is caused by an underlying condition, that condition is treated first, followed by symptomatic and supportive therapy for the hypotonia. Physical therapy can improve fine motor control and overall body strength. Occupational and speech-language therapy can help breathing, speech, and swallowing difficulties. Therapy for infants and young children may also include sensory stimulation programs. Specific treatment for hypotonia is determined by the child's physician based on the following:

• the child's age, overall health, and medical history
• the extent of the condition
• the underlying cause of the condition
• the child's tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• parent opinion or preference

No specific treatment is required to treat mild congenital hypotonia, but children with this problem may periodically need treatment for common conditions associated with hypotonia, such as recurrent joint dislocations. Treatment programs to help increase muscle strength and sensory stimulation programs are developed once the cause of the child's hypotonia is established. Such programs usually involve physical therapy through an early intervention or school-based program among other forms of therapy.
Hypotonic children are often treated by one or more of the following specialists:

• Developmental pediatrician: a pediatrician with specialized training in children's social, emotional, and intellectual development as well as health and physical growth. He or she may conduct a developmental assessment which will determine any delays the child has and to what extent the delay is present.
• Neurologist: a physician who has trained in the diagnosis and treatment of nervous system disorders, including diseases of the brain, spinal cord, nerves, and muscles. Neurologists perform neurological examinations of the nerves of the head and neck; muscle strength and movement; balance, ambulation, and reflexes; and sensation, memory, speech, language, and other cognitive abilities.
• Geneticist: a specialist in genetic disorders. He or she starts with the detailed history of the family's background, looks at the child's features and orders blood tests to look at the 46 chromosomes and possibly at specific genes on those chromosomes.
• Occupational therapist (OT): a professional who has specialized training in helping to develop mental or physical skills that help accomplish daily living activities, with careful attention to enhancing fine motor skills. In a developmental assessment, the occupational therapist assesses the child's fine motor skills, coordination, and age-appropriate self-help skills (eating with utensils, dressing, etc.).
• Physical therapist (PT): a professional trained in assessing and providing therapy to treat developmental delays using methods such as exercise , heat, light, and massage. In a developmental assessment, the physical therapist assesses the ability and quality of the child's use of legs, arms, and complete body by observing the display of specific gross motor skills as well as observing the child in play.
• Speech/language pathologist (SLP): a professional who is trained in assessing and treating problems in communication. Some SLPs are also trained to work with oral/motor problems, such as swallowing, and other feeding difficulties resulting from hypotonia.