I am in need of a medical opinion about my son's possible Hypotonia. At nine months my son was referred by our pediatrician to physical and occupational therapy because he was not sitting up, rolling over, feeding himself, holding his bottle, etc. He was very content and seemed very aware but would physically just lay there moving his little arms and legs. He excelled with his fine motor skills and was discharged from occupational therapy after only a month and a half. He began feeding himself and using his little fingers to pick things up. However, his gross motor skills were still a struggle and I continued working with him everyday and taking him to PT once a week in order to get him to roll over....sit up (not fall over when in a sitting position) and eventually, crawl. His physical therapist diagnosed him as having Hypotonia. Despite this he continued to progress week by week getting stronger with every accomplishment. By 14 months he was walking but his balance and reflexes were not good. I used a harness to prevent hard falls as he did not have the reflexes to put his hands out and protect himself or to sit when falling backwards...he would basically fall straight back like a tree. At the recommendation of his physical therapist, I took him to a Development Pediatrician who seemed pleased with the fact that he was in fact progressing. He tested him for Muscular Dystrophy (which came back negative, thank goodness) and didn't see any indication of any other problems. After roughly four and a half months of Physical Therapy he was discharged due to his progress. With exercise and practice, my son's balance and core strength has improved and he has developed the reflexes to protect himself when he falls (although the reflexes could still be a little faster).
My son is now 16 months and one week. Despite a few things that we are still working on, you would never know that he had the above struggles. So here's where my question begins: Do you really think that my son may have Hypotonia or could there be another explanation?
My son has or had three symptoms that are consistent with Hypotonia: His joints hyper extended when pressure or weight was applied (they do not hyperextend anymore). The more muscle he's built the less the hyperextension. There were slight delays with his milestones. And lastly, he seemed to have the low muscle tone as it was initially difficult for him to do things such as sit up, get on all fours, pull himself up, stand, etc.
Even though the symptoms above do sound like Hypotonia, there are many symptoms of Hypotonia that are not consistent with my son: From what I've read, Hypotonia is usually a symptom of another illness or disorder. There are no underlying conditions causing the Hypotonia in his case. He had good head control from an appropriate age, he wasn't limp like a rag doll (he didn't grasp onto you strongly but he wasn't limp), he doesn't tire easily, although his milestones were delayed and took some extra work...he still accomplished them within a reasonable age range, he has began speaking...saying little words here and there and does tons and tons of babbling while mimicking inflection and even melodies to songs...so he doesn't seem to have any muscle issues with his jaw. These along with other things I've read about Hypotonia make me think that my son does not have this disorder. Just this morning, he was pushing and pulling my dining room chairs all over the house. The chairs are oversized and pretty heavy. He did this for over 30 minutes and showed no signs of tiring.
Cognitively, he is right on target. Physically, he is SO close. We are still working on him climbing stairs and quickening his reflexes but that's it. He's accomplished everything else. He runs around with other kids, etc (although is sometimes more likely to fall). Unfortunately, he fell forward last week and fractured his wrist. I have a hunch that the break may have been due to a slight delay in putting his hands down...but the nurse did say that this is a common injury for children of his age...perhaps it was a fluke thing or maybe it was delayed reflexes. Meanwhile we will keep working the other muscles with lots of play.
Do you think that he may just have had some joint issues and muscle weakness? He is really overcoming this which doesn't seem typical of Hypotonia. I completely understand that you cannot diagnose him with an e-mail but I would love to get your professional opinion about my son. He is doing so well, but I still worry and would truly appreciate your thoughts.
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