Causes & clinical presentation of hypotonia in children

Abstract EN

Background : Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders.

The long-term effects of hypotonia on a child's development and later life depend primarily on the severity of the muscle weakness and the nature of the cause.

Patients & Methods : A prospective, cross sectional descriptive study in which 62 patients with hypotonia, age 3months to13 years, were evaluated in children welfare teaching hospital / Baghdad (a tertiary care center), over 4months Period (1st of January to 1st of May, 2008).

Children were categorized into groups of central, peripheral & systemic hypotonia, and specific diagnosis of each of groups was made by clinical findings, neuroimaging, metabolic, muscular enzymes, Electromyography-Nerve conduction velocity, thyroid function tests, Serum Calicium & X-RAY of left wrist, & TORCH (Toxoplasmosis, others, rubella, CMV, herps simplex) assay in our medical teaching laboratories.

Results : The most common cause of hypotonia was central in 30 patients (48.4 %).

(Four patient with unknown causes), the most common lesion was brain atrophy detected by CT scan examination in 23 / 30 (76.7 %).

Peripheral causes found in 14 / 58 (22.6 %) which include myopathies in 7 patients (11.3 %), anterior horn cell lesion in 7 patients (11.3 %).

Systemic causes were found in 14 / 58 (22.6 %).

Early Onset in 46 / 62 (74.2 %), while late onset constituted 16 / 62 (25.8 %).

The most common mode of presentation is delayed mile stones found in 32 patients (51.6 %).

Conclusions : The most common cause of hypotonia in children enrolled in the study is central lesion and commonly occurs in pre natal, natal & post natal periods.

The most common finding is brain atrophy diagnosed by CT scan, while the most common presentation is delayed milestones, and most common type of weakness is proximal.