Hypotonia-Causes, Signs and Treatment

Hypotonia is more a description than a diagnosis. It is most often seen in newborns (congenital) and infants, but it may persist through adolescence into adulthood. Another name for infantile hypotonia is "floppy baby syndrome." This refers to the tendency of a hypotonic infant''s arms, legs, and head to "flop," or dangle loosely, when they are picked up or moved.

Hypotonia is more a description than a diagnosis. It is most often seen in newborns (congenital) and infants, but it may persist through adolescence into adulthood. Another name for infantile hypotonia is "floppy baby syndrome." This refers to the tendency of a hypotonic infant''s arms, legs, and head to "flop," or dangle loosely, when they are picked up or moved. In the past, the term "benign congenital hypotonia" was used for many cases in which no obvious cause for the hypotonia could be detected.

Hypertonia: Increased tightness of muscle tone. Untreated hypertonia can lead to loss of function and deformity. Treatment is by physical and/or occupational therapy, and in some cases muscle relaxant medication. Injections of botulism toxin (botox) are a recent treatment for chronic hypertonia in cerebral palsy and other disorders. Also known as spasticity.

Hypotonia is quite devastating even though it can almost be invisble to a parent. 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, so you are often told your kid has hypermobility as well - which simply means the joints move excessively in comparison to other peoples'' joints.

Causes

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Signs

Hypotonic patients may display a variety of objective manifestations that indicate decreased muscle tone. Motor skills delay is often observed, along with hypermobile or hyperflexible joints, drooling and speech difficulties, poor reflexes, decreased strength, decreased activity tolerance, rounded shoulder posture, with leaning onto supports, and poor attention and motivation. The extent and occurrence of specific objective manifestations depends upon the age of the patient, the severity of the hypotonia, the specific muscles affected, and sometimes the underlying cause. For instance, some hypotonics may experience constipation, while others have no bowel problems.

Treatment

Treatment begins with a thorough diagnostic evaluation, including an assessment of motor and sensory skills, balance and coordination, mental status, reflexes, and functioning of the nerves. Diagnostic tests such as a CT scan of the brain, an EMG to evaluate nerve and muscle function, or an EEG to measure electrical activity in the brain may also be necessary. Once a diagnosis has been made, the underlying condition is treated first, followed by symptomatic and supportive therapy for the hypotonia.

Physical therapy to prevent muscle atrophy and maintain joint mobility, and measures to try and prevent opportunistic infections such as pneumonia. Treatments to improve neurological status might involve such things as medication for a seizure disorder, medicines or supplements to stabilize a metabolic disorder, or surgery to help relieve the pressure from hydrocephalus (increased fluid in the brain). If the neurologic condition is untreatable, physical and occupational therapy may help to improve muscle tone, strength, and coordination.

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