Hypotonia

What is it?
A diagnosis of benign congenital hypotonia (BCH) is sometimes considered a form of muscular dystrophy or cerebral palsy, depending on the symptoms and the doctor. If the cause of the hypotonia is thought to lie in the brain, then it might be classified as a cerebral palsy. If the cause seems to be in the muscles, it might be classified as a muscular dystrophy, even though most forms of BCH are not seriously dystrophic. If the cause is thought to be in the nerves, it could be classified as either or neither. In any case, BCH is rarely an actual muscular dystrophy or cerebral palsy, and it is often not classified as either one, or anything at all for that matter.

Hypotonia can be a symptom of:

  • Cerebral Palsy
  • Muscular Dystrophy
  • An Unknown Origin

What are the symptoms?
BCH is normally discovered within the first few months of life. Or rather, symptoms are noticed within a few weeks to a year (sometimes with a provisional label of "failure to thrive").

Symptoms include:
  • General weakness and flaccidity of the muscles (reduced strength and endurance). Depending on the underlying disease, different sets of muscles may be involved.
  • Poor reflexes.
  • Hypermobility of joints (how far back can you bend your fingers?). Hypotonic children often find it comfortable to sit in the "W" position and other painful or contortionist looking postures.
  • Inability to lift the head, rolling instead of crawling (shuffling on their bottoms).
  • Physical passivity.
  • The child feels like a sack of Jell-O when you pick the child up - he or she wants to slide out of your hands.
  • Poor sucking (and feeding).
  • Weak cry.
  • Delayed gross and fine motor development.
  • Constipation for those whose bowel muscles are affected.

How is it treated?
The outcome in any particular case depends largely on the nature of the underlying disease. Often, therapists (speech, physical and occupational) work together to treat the child.

Examples:
  • For general weakness and flaccidity of the muscles
    Physical therapists work on motor skills to strengthen muscles.
  • For poor reflexes
    Physical therapist will work to increase reflexes, such as hand and ball coordination Typically the hypotonia does not get much worse, and it sometimes improves. Hypotonia does not intrinsically affect intelligence, though a number of underlying diseases may have adverse affects on one or more aspects of cognition.

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