Neonatal HypotoniaClinical Approach To Floppy Baby[新生儿肌张力低下的临床方法要软盘婴儿](PPT-31).pptVIP

Neonatal HypotoniaClinical Approach To Floppy Baby Osama Naga, M.D., PGY2 7/23/09 Neonatal Hypotonia 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) Neonatal Hypotonia Spinal cord Birth trauma (especially Breech delivery) Syringomyelia Neonatal Hypotonia Anterior Horn Cell Spinal Muscular Atrophy Traumatic myelopathy Neonatal Hypotonia Neuromuscular junction Congenital myasthenia gravis Transient acquired neonatal myasthenia Infantile botulism Neonatal Hypotonia Muscle Muscular dystrophies (congenital myotonic dystrophy) Congenital myopathies (e.g. central core disease) Neonatal Hypotonia Peripheral nerves Hereditary sensory motor neuropathies Charcot-Marie-Tooth disease Neonatal Hypotonia Metabolic myopathies Acid maltase deficiency Carnitine deficiency Cytochrome-c-oxidase deficiency Neonatal Hypotonia History Any significant family history Affected parents Siblings Consanguinity Stillbirths Childhood deaths Neonatal Hypotonia History Maternal disease Diabetes Epilepsy Myotonic dystrophy Pregnancy and delivery history Drug or teratogen exposure Decreased fetal movements Abnormal presentation Polyhydramnios/ oligohydramnios Neonatal Hypotonia History Apgar scores Resuscitation requirements Cord gases Neonatal Hypotonia History History since delivery Respiratory effort Ability to feed Level of alertness Level of spontaneous activity Character of cry 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 examiners hands Neonatal Hypotonia Identification of hypotonia Holding the infant in horizontal suspension The back hangs over the examiners hand, and the limbs and