Neonatal Hypotonia
Identification of hypotonia
Holding the infant under the arms
The legs will be extended
Decreased tone of the shoulder girdle allows the infant to slip through the examiner's hands

Identification of hypotonia
Holding the infant in horizontal suspension
The back hangs over the examiner's hand, and the limbs and head hang loosely
Passive extension of the legs at the knees no resistance is met
Pulling the infant from the supine to sitting position the head lags and continues to lag when the sitting position is reached

Central Causes
Cerebral palsy
Hypoxic ischemic encephalopathy
Intracranial hemorrhage
Cerebral malformations
Chromosomal abnormalities (e.g.Trisomy 21, Prader-Willi syndrome)
Congenital infection TORCH
Acquired infections
Peroxisomal disorders
Drug effects (e.g. benzodiazepines)

Spinal cord
Birth trauma (especially Breech delivery)

Anterior Horn Cell
Spinal Muscular Atrophy
Traumatic myelopathy

Neuromuscular junction
Congenital myasthenia gravis
Transient acquired neonatal myasthenia
Infantile botulism

Muscular dystrophies (congenital myotonic dystrophy)
Congenital myopathies (e.g. central core disease)

Peripheral nerves
Hereditary sensory motor neuropathies
Charcot-Marie-Tooth disease

Metabolic myopathies
Acid maltase deficiency
Carnitine deficiency
Cytochrome-c-oxidase deficiency

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