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Diagnosis of Floppy infant:
Diagnosis of severe hypotonia depends on the presence of the following
signs:
Frog leg position: denotes hypotonia of lower limbs.
Head lag: when the baby is pulled up from his hands, while in supine
position, the head lags backwards → denotes hypotonia of neck muscles.
Curved trunk on ventral suspension: When the baby is suspended in prone
position over the examiner's hand → drops around it, → denotes hypotonia of
trunk muscles.
Slippage on vertical suspension : denotes hypotonia of shoulder girdle
muscles
Diagnosis the cause of hypotonia :
• Cerebral hypotonia : the following criteria are suggestive
- Abnormal brain functions; seizures, disturbed conscious level.
- Mental retardation.
- Dysmorphic features of chromosomal disorders e.g. down syndrome or
other.
- Hypereflexia.
• Lower motor unit disorders: the following criteria are suggestive
-A reflxia or hyporeflexia.
-Muscle atrophy & fasciculations.
-Total loss of reflexes with residual movements → neuropathy.
-Diminished reflexes consistent with the degree of muscle weakness →
myopathy.
Previous last two conditions are differentiated by doing Nerve conduction
velocity and Electroencephalogram.
