Hypotonic Syndrome

This article was written by dr. Aursulesei Ruxandra, pediatric neurologist with extensive experience in diagnosing and treating neurological conditions. Pediatric neurology plays an important role in the periodic neurological evaluation of children born prematurely, as well as of all newborns at risk of developing neurological sequelae, with the goal of early detection and treatment of any impairment of the nervous system.

What is Hypotonia?

Hypotonia is a decrease in muscle tone. 

What does Hypotonic Syndrome look like?

A hypotonic infant may adopt bizarre or unusual postures (the "frog-leg" position), shows reduced active movement, may have abdominal-type breathing, and delayed staged development. Physically, one may notice: pectus excavatum, and the chest may take on a funnel shape with a wide base at the bottom. 

Are there several degrees of Hypotonia?

Yes. Hypotonia can range from mild to severe. 

Centrokinetic is well prepared for this specialty, with a team of experienced doctors and the necessary equipment for diagnosis, monitoring, and treatment. Find out more about pediatric neurology and book an appointment at Centrokinetic here.

What can cause Hypotonic Syndrome?

There are multiple causes:

Chromosomal abnormalities:

• Prader-Willi syndrome
• Cerebral dysgenesis
• Cerebro-hepato-renal syndrome
• Chromosomal aberrations

Cerebral palsy: 

• Hypotonic type 
• Mixed type

Metabolic diseases

• Hypocalcemia
• Hypercalcemia
• Hyperlysinemia
• Hyperglycinemia
• Hyperammonemia
• Fucosidosis
• Gangliosidosis (GM1)
• Tay-Sachs disease
• Cytochrome C oxidase deficiency
• Carnitine deficiency
• Mannosidosis
• Lowe syndrome
• Organic acidemias
• Renal tubular acidosis
• Hypothyroidism

Acute CNS conditions

• Stroke
• Hypoxic-ischemic encephalopathy
• Infections
• Trauma

Toxic causes

• Sedative medications
• Antiepileptic medications
• Bilirubin
• Magnesium

Anterior horn cell conditions

• Acute progressive spinal muscular atrophy
• SMA III
• Poliomyelitis 

Peripheral nerve conditions

• Congenital sensory neuropathies
• Acute polyneuropathies
• Chronic sensorimotor polyneuropathies
• Neuromuscular junction disorders
• Transient neonatal Myasthenia Gravis
• Neonatal Myasthenia Gravis 
• Botulism
• Hypermagnesemia
• Antibiotics (aminoglycosides)

Muscle conditions

• Congenital myopathies
• Metabolic myopathies
• Inflammatory myopathies
• Myotonic dystrophy
• Congenital muscular dystrophies without CNS involvement

Miscellaneous

• Hypothyroidism
• Arthrogryposis
• Connective tissue diseases

Central and peripheral motor unit conditions

• Adrenoleukodystrophy
• Fukuyama muscular dystrophy and encephalopathy
• Infantile neuroaxonal dystrophy
• Globoid cell leukodystrophy 
• Metachromatic leukodystrophy
• Niemann-Pick disease
• Zellweger syndrome

("Neuromuscular Conditions in the Infant, Child, and Adolescent", Sanda Magureanu)

How is hypotonia treated?

The underlying disease is treated. Kinesiotherapy also plays an essential role in improving the motor deficit, as well as in preventing contractures.