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Floppy InfantAka: Hypotonic Infant, Infantile Hypotonia

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  1. Signs: Perform complete physical examination
    1. Infant with decreased muscle tone
    2. Exam distinguishes site of disorder
      1. Upper motor neuron lesion
      2. Lower motor neuron lesion
  2. Differential Diagnosis: Upper Motor Neuron Causes
    1. Chromosomal
      1. Turner's Syndrome
      2. Down's Syndrome
      3. Prader-Willi Syndrome
    2. Infection
      1. Sepsis
      2. Meningitis
      3. Encephalitis
    3. Metabolic
      1. Hypocalcemia
      2. Hyponatremia
      3. Hypermagnesemia
      4. Hypoglycemia
      5. Hypothyroidism
      6. Aminoaciduria
      7. Gangliosidoses
      8. Hepatic Encephalopathy or Reye's Syndrome
    4. Toxin
      1. Drug Intoxication (e.g. Alcohol, Narcotic)
      2. Heavy metal poisoning
      3. Organophosphate Poisoning
      4. Anticholinergic exposure
    5. Perinatal trauma
      1. Perinatal asphyxia (HIE)
      2. Hemorrhage
  3. Differential Diagnosis: Lower Motor Neuron Causes
    1. Brainstem or spine
      1. Spinal muscular atrophy (Anterior Horn Cell Disorder)
      2. Infection
        1. Poliomyelitis
        2. Coxsackie Virus
    2. Neuromuscular Junction
      1. Congenital Myasthenia Gravis
      2. Myasthenic syndrome
      3. Guillain Barre Syndrome
      4. Botulism
    3. Muscle
      1. Muscular Dystrophy
      2. Congenital Myopathy
      3. Inflammatory Myopathy
    4. Other
      1. Tick Paralysis
      2. Benign congenital hypotonia
  4. Radiology
    1. Head CT
    2. Head MRI
  5. Diagnostic Studies
    1. Electromyogram (EMG)
    2. Nerve Conduction Studies
  6. Labs: Initial
    1. Serum electrolytes
    2. Serum Calcium
    3. Serum Glucose
    4. Creatine Phosphokinase (CPK)
    5. Blood Culture
    6. Lumbar Puncture with Cerebrospinal Fluid Examination
    7. Thyroid Function Tests
  7. Labs: Test as indicated
    1. Toxicology screen
    2. Serum Ammonia and Venous pH
      1. Serum amino acids
      2. Urine amino acids and organic acid
    3. Karyotype
    4. TORCH Virus Screening

Floppy infant syndrome (C0270971)

ConceptsCongenital Abnormality (T019) , Disease or Syndrome (T047)
English'Floppy' infants, Congenital hypotonia, Floppy baby, Floppy infant, Floppy infant syndrome
Spanishbebe flácido, bebe flacido, síndrome del lactante hipotónico, sindrome del lactante hipotonico
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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