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Floppy Infant
Aka: Floppy Infant, Hypotonic Infant, Hypotonia in Infants, Infantile Hypotonia, Neonatal Hypotonia, Congenital Hypotonia- Signs: Perform complete physical examination
- Infant with decreased Muscle tone
- Exam distinguishes site of disorder
- Differential Diagnosis: Upper Motor Neuron Causes
- Chromosomal
- Turner's Syndrome
- Down's Syndrome
- Prader-Willi Syndrome
- Infection
- Metabolic
- Toxin
- Drug Intoxication (e.g. Alcohol, Narcotic)
- Heavy Metal Poisoning
- Organophosphate Poisoning
- Anticholinergic exposure
- Perinatal Trauma
- Perinatal asphyxia (HIE)
- Hemorrhage
- Chromosomal
- Differential Diagnosis: Lower Motor Neuron Causes
- Brainstem or spine
- Spinal muscular atrophy (Anterior Horn Cell Disorder)
- Acute Flaccid Paralysis
- Infection
- Poliomyelitis
- Coxsackie Virus
- Neuromuscular Junction
- Muscle
- Muscular Dystrophy
- Congenital Myopathy
- Inflammatory Myopathy
- Other
- Tick Paralysis
- Benign Congenital Hypotonia
- Brainstem or spine
- Imaging
- Diagnostic Studies
- Labs: Initial
- Serum Glucose (obtain immediately on presentation)
- Serum Electrolytes
- Serum Calcium
- Creatine Phosphokinase (CPK)
- Blood Culture
- Lumbar Puncture with Cerebrospinal Fluid Examination
- Thyroid Function Tests
- Labs: Test as indicated
- Toxicology screen
- Serum Ammonia and Venous pH
- Serum amino acids
- Urine amino acids and organic acid
- Karyotype
- TORCH Virus Screening