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Hypotonia with some spasticity?
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Hypotonia with some spasticity?

Hi,  We've recently had our three year old daughter (born at 37 weeks) evaluated by a PT because of delays in gross motors skills, particularly in her legs.  The PT noted hypotonia in her legs, arms, and partiularly her trunk and abdomen.  I'm planning on taking her to a neuro for further evaluation, but it's been difficult to ge them to call me back for an appointment.

The dx at this point is idiopathic congenital hypotonia.  However, she has notable *limited* ROM in her right ankle (causing most of the problems that were obvious to me).  Her ankle doesn't flex more than 10 degrees, even with pressure from the PT.  That doesn't seem like hypotonia to me, but the PT thinks it could be a compensatory mechanism.  I haven't read anything like that, but I'm new to this.  Does this sound like a mild case of CP?  Our pediatrician said it's possible/likely the neuro will give that dx.  Will the therapy change at all if it is?

I'm sure lots of parents feel this way, but I feel like I should have picked it up sooner.  She was slower to do a lot of things than her sisters, but I chalked it up to personality (she would always just sit and watch everything) and being born 3 weeks earlier than her older sisters.  I did mention things to her pediatricians along the way--she didn't roll over until 8 months--but she was always within the normal range (and in fact walked at 12 months, right on target).

While we wait to see the neuro, is there anything else we should be doing?  We've started weekly PT sesions and are doing some of the "games" at home daily or every few days.

Thanks.

Stephanie
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Hello and welcome!
Hypotonia may be suggestive of a problem anywhere along the pathway that controls muscle movement. There can be several causes of this hypotonia like brain damage or encephalopathy due to lack of oxygen before or immediately after birth, defects in brain formation etc.Motor neuron diseases, muscular dystrophies are other  causes of hypotonia.Near term  delivery ,delayed milestones and associated movement, balance, and posture disorders all indicate the possibility of cerebral palsy in your daughter. Hypotonic CP is very rare compared to a spastic CP.Hypotonia is generally associated with damage to the cerebellum which controls balance and coordination. Only a complete clinical examination can help in arriving at an accurate diagnosis. It is best to consult a Pediatric neurologist. Do keep us posted.
Take care and Regards!
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