Hypotonia (Low Muscle Tone)

Hypotonia in a baby refers to low muscle tone. Also known as floppy baby syndrome, hypotonia could be a temporary condition. Sometimes it is a sign of a congenital issue involving the central nervous system or muscles. Muscular dystrophy, cerebral palsy and spinal muscular atrophy are among the conditions characterized by a progressive loss of muscle tone.

Health care providers often will detect a baby’s hypotonia shortly after birth. The APGAR score (appearance, pulse, grimace response, activity and respiration) measures muscle tone as part of the activity evaluation. “Active, spontaneous movement” warrants two points. “Arms and legs flexed with little movement” scores one point. “No movement, ‘floppy’ tone” gets zero points.

Hypotonia in a baby is the opposite of hypertonia, or too much muscle tone, that causes stiffness and difficulty moving.

More families in Louisville and Southern Indiana choose Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, than any other pediatric neuroscience care provider. Our board-certified and fellowship-trained neurologists have state-of-the-art tools and training to evaluate your child’s condition. Their skills and experience diagnosing and treating hypotonia help determine whether the condition will resolve itself or is a symptom of another condition.

A precise diagnosis guides a customized plan to help your baby grow into an active child.

What Is Muscle Tone?

Muscle tone refers to the tension and stiffness in the muscles even when relaxed. Think of the muscles in your neck holding your head up. Sleep reduces muscle tone, so your head may fall forward if you fall asleep sitting up.

Muscle strength isdifferent from muscle tone. It refers to the muscle’s ability to contract and create force when in use. Muscle tone refers to the muscle at rest.

Diagnosing the Cause of Hypotonia in a Baby

If hypotonia in a baby is a concern for a more serious condition, Norton Children’s Neuroscience Institute child/pediatric neurologists may conduct additional tests. These could include an evaluation of how your child metabolizes sugar, fat and protein. Specialists also may perform a magnetic resonance imaging (MRI) scan to examine your child’s brain and/or spinal cord. Genetic testing also may be helpful.

Some tests, such as an MRI, can be scary for children, and we can provide sedation if needed.

In some cases, we may need to measure the electrical activity of nerves and muscles using electromyography (EMG). We also may need to remove a small amount of muscle tissue for testing.

Determining a precise diagnosis helps our neurologists map out a plan that could include working with our team’s physical therapists and occupational therapists to help improve muscle tone. If necessary, speech therapists also are available.

In some babies, hypotonia can lead to musculoskeletal issues. They may require visits with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. Throughout your child’s treatment, physical medicine and rehabilitation specialists help ensure your child has everything they need to thrive.

  • The Norton Children’s Hospital Comprehensive Epilepsy Center is a Level 4 epilepsy center, the highest rating available from the National Association of Epilepsy Centers. Norton Children’s Hospital has held this designation since 2013.

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  • As the first to use many diagnostic tools and treatments, specialists with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, have extensive experience in areas such as pediatric neurostimulation, immune-mediated neurological disorders, magnetic resonance imaging (MRI)-guided laser ablation surgery and virtual reality brain imaging.
  • Regional neurology care is available for children across Kentucky and Southern Indiana. Our specialists are available at clinics in Bowling Green, Campbellsville, Corbin, Elizabethtown, Frankfort, Owensboro and Paducah, Kentucky; and Evansville, Indiana. Telemedicine visits also are available.
  • Many neuroscience patients benefit from treatment by a range of specialists. To allow families to schedule multiple visits in the same day with a broad range of views from specialists, we offer multidisciplinary clinics:
  • Our neuropsychology specialists evaluate children and teens with a variety of neurological, neurodevelopmental and medical conditions, including brain tumors and epilepsy.
  • Communicate with your child’s neuroscience and other health care providers, get test results, schedule appointments, refill prescriptions and more with a free MyNortonChart account.
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