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 Vol. 19 No. 6, June 2008
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AAP Grand Rounds 19:66 (2008)
© 2008 American Academy of Pediatrics

NEUROLOGY

Diagnostic Approach to Neonatal Hypotonia

Source: Laugel V, Cossee M, Matis J, et al. Diagnostic approach to neonatal hypotonia: retrospective study on 144 neonates. Eur J Pediatr. 2008;167(5):517–523; doi:10.1007/s00431-007-0539-3[CrossRef][Medline]

The first 20% of the full text of this article appears below.


PICO

Question: In neonates with hypotonia, how well does the initial examination predict whether the infant has central or peripheral type hypotonia?

Question type: Diagnosis

Study design: Retrospective review

 

The frequency of various disorders causing neonatal hypotonia and the reliability of the first physical examination and standard diagnostic tests were evaluated by a review of medical records of patients diagnosed between 1999 and 2005 at Strasbourg University Hospital, France. Patients were only eligible for inclusion if hypotonia had first been noticed before the 28th day of life and had lasted for at least two weeks. Exclusion criteria were gestational age less than 35 weeks and obvious extra-neurological diagnosis (eg, neonatal infection and congenital heart failure). Initial presentation of hypotonia was classified as central, peripheral, or undetermined, according to the following criteria: infants with central hypotonic cases had preserved antigravity limb movements; normal or increased peripheral tone; poor visual contact; seizures; and brisk tendon reflexes. Peripheral hypotonia was characterized by muscular weakness, absent antigravity movements, decreased reflexes, global hypotonia, and preserved social interaction.

A total of 144 . . . [Full Text of this Article]

J. Gordon Millichap, MD, FAAP
Neurology, Children’s Memorial Hospital, Northwestern University Medical School, Chicago, IL

 





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