Muscle hypotension is understood by the physician to mean low muscle tension and simultaneous weakness of the musculature, which is already noticeable in childhood. It always occurs as a symptom of an underlying disease and is treated with physiotherapy.

What is a hypotonia?

The term muscle hypotonia is composed of muscles and the Latin word "hypotonic", which means "diminished strength or tension" and is in itself a very accurate description of the symptoms.

Affected suffer from a greatly reduced power in particular the striated muscles. This muscle group includes the heart and skeletal muscles, and especially the muscles of the body, which are responsible for voluntary, actively controlled movements.

A hypotonia becomes conspicuous because the affected persons have to move very little and have to exert their efforts far beyond normal levels. In childhood, for example, parents notice the child's abnormal exertion when breastfeeding.

causes

The causes of hypotonia are manifold, as they always occur as a symptom of other underlying diseases, but never as a separate disease.

As a rule, infants are already affected, one then speaks of an infantile hypotonia. The most common underlying diseases include metabolic disorders, the congenital neuromuscular disorder nemaline myopathy and neurological disorders, alcohol embryopathy and various other congenital disorders. In the following, the most important are briefly presented.

Alcohol embryopathy is a disorder characterized by significant alcohol consumption during pregnancy, usually in children of alcoholic mothers. The symptoms are reduced growth, mental retardation, behavioral problems and hypotonia. Even with the congenital trisomy 13 (Pätau syndrome), Edwards syndrome and the Down syndrome, the hypotonia belongs to the symptoms.

In rare cases, the first manifestation of hypotonia only in advanced age, as the trigger then autoimmune diseases such as multiple sclerosis or Parkinson's disease or traumatically acquired damage to the central nervous system can be identified.

Symptoms, complaints & signs

A hypotonia manifests itself first by balance disorders, muscle hardening and paralysis. In the long term developmental delays of the musculoskeletal system, resulting in malpositions and muscle pain can occur. Muscle weakness also affects the respiratory system and lungs.

Possible symptoms are speech and swallowing disorders as well as shortness of breath. In some patients the voice color changes or a complete loss of voice occurs. As hypotonia progresses, a fatigue syndrome sets in. The child then complains of pain and tiredness after physical exertion, often accompanied by an increasing listlessness.

The reduced activity is usually associated with loss of appetite and emotional upsets. If the cause of hypotonia is not treated, symptoms progress. This quickly leads to a decrease in quality of life and well-being. In addition, as a result of the weakness maladjustments occur, which are associated with other health risks.

Possible consequences of a persistent malposition are joint wear, muscle pain and tension. The muscle weakness may also promote circulatory disorders and sensory disturbances. The vessels are also burdened by the reduced muscle activity. If diagnosed early, the symptoms of hypotension resolve quickly. The majority of patients are symptom-free no later than one to two months after treatment.

Diagnosis & History

The parents usually suspect muscle disorders in infants. Muscular hypotension is characterized by very little exercise compared to the age group, great effort for example in breastfeeding, and reduced ability to lift the head.

Visiting a pediatrician is strongly recommended in this case. He will obtain a detailed medical history of the symptoms observed by the parents and possible risk factors before thoroughly examining the child physically.

Depending on the age of the patient, the diagnosis is different. Relevant are the posture of the patient during standing and walking, lying and sitting, his motor skills and motor endurance. Ultimately, it must also be diagnosed which muscle groups are most affected.

The prognosis of hypotonia depends on the underlying disease, but no general statement can be made.

complications

As a rule, hypotonia itself is a complication. For this reason, especially the underlying disease is treated, which leads to hypotonia. The complaint itself can significantly restrict the daily life of the person concerned and lead to complaints in the movement and in various activities. Similarly, the development of the child is significantly limited by the disease.

The patients suffer from a strong muscle weakness and thus also at a significantly reduced load capacity. Also, the posture of the patient is not straight and can thus have a negative impact on adulthood and possibly lead to irreversible consequential damage. The muscles are very weak, so that the exercise of different sports for the person concerned is usually no longer possible.

The treatment itself takes the form of treatment of the underlying disease. Whether complications may arise can not generally be predicted universally. With the help of various therapies, most complaints can be alleviated and restricted so that there are no secondary complications in adulthood. The life expectancy of the patient is usually not limited by the hypotonia.

When should you go to the doctor?

Musculoskeletal disorders are considered unusual. If they persist or increase in intensity, a doctor is needed. If general physical fitness is reduced, medical advice should be sought. Musculoskeletal pain, paralysis or limitation of natural movement should be consulted by a physician. If there is a developmental delay in children, dysphagia or phonation problems, a doctor should be consulted. Apathy, indifference or diminished well-being are signs of an existing irregularity.

Consultation with a doctor is necessary as soon as the symptoms persist for several weeks or show increasing tendency. If the person concerned no longer participates in usual social activities, mood swings or other behavioral abnormalities occur, should a doctor visit be made. In the case of loss of appetite, an unwanted decrease in body weight or an increased need for sleep, there is an impairment of the organism.

If there are problems with sleep, if there are abnormalities in the vocal system or if changes in the skeletal system occur, a doctor is needed. In the case of a permanent malposition or an oblique posture during locomotion, a timely correction must be made so that there are no lifelong disturbances. If the person concerned can no longer take part in usual sports activities due to the impairments, a doctor should be consulted.

Treatment & Therapy

The treatment of hypotonia in two ways: On the one hand, the underlying disease must be treated as well as possible, on the other hand, with physiotherapeutic measures is trying to expand the mobility.

The underlying diseases can be treated differently depending on severity and exact syndrome: While there is no effective therapy for either the Edwards syndrome or the Pätau syndrome, and children with these trisomies have a generally low life expectancy, the chances of those affected by Down syndrome are high better.

Concerned with good early intervention with therapeutic pedagogical, occupational therapy, physiotherapeutic and psychomotor procedures, those affected have prospects of almost normal physical activity. The hypotonia induced by alcohol embryopathy is also treatable so well that affected children can achieve almost normal physical activity.

Physiotherapeutic measures are aimed at improved posture control, conscious fine motor movements and a metered exertion of force. The exercises to be learned and the duration of the treatment are individually tailored to the affected muscle groups and the severity of the symptoms.

The exercises can be done on equipment, for example in a roll-on or on the so-called horse, and without aids and must be carried out daily.

Outlook & Forecast

Patients have good prospects for a life with almost normal physical activity with timely early intervention and ergotherapeutic and physiotherapeutic therapies. The therapeutic measures are aimed at improved posture control, as well as more conscious fine motor movements with metered force. The learning of the exercises as well as the duration of the therapy are directed individually to the affected muscles and the occurring symptoms. These exercises can be done on special devices and without any aids. The exercises should be done daily. The illness can considerably limit the everyday life of the patients.

The hypotonia leads in particular to discomfort in moving and when performing various activities. The development of children suffering from hypotonia is also very limited. Those affected suffer from a very strong muscle weakness and thus also at a greatly reduced load capacity. Also, the posture of those affected is not straight and thus has a negative impact on the subsequent development. The wrong posture can even lead to incurable consequential damage.

In general, the muscles are very weak, so that the exercise of different sports for those affected is usually no longer possible. With the help of the different treatment methods, however, most complaints can be alleviated, so that no subsequent damage occurs. Life expectancy is usually not limited.

prevention

Since the causes of hypotonia are manifold and not all underlying diseases can be influenced, there are no possibilities for prevention. It is recommended to pay attention to a healthy, child-friendly diet during pregnancy.

aftercare

In the case of hypotonia, the affected person usually has only very few and often only limited measures of direct aftercare available. The affected person should therefore contact a doctor as early as possible so that it does not come to other complaints or complications. The sooner a doctor is visited, the better is usually the further course of the disease.

An early diagnosis usually has a positive effect on the further course of hypotonia. The patients themselves are usually dependent on the measures of physiotherapy and physiotherapy. Many of the exercises can also be done in one's home to speed healing. Similarly, parents should look after their children for a correct posture to relieve the symptoms.

Frequently, those affected by hypotonia also rely on the help and support of their own family in everyday life. This can also prevent depression and other mental upsets. The contact with other patients of the disease can be very useful, since it is not uncommon for an exchange of information. The disease usually does not reduce the life expectancy of the person affected.

You can do that yourself

Hypotonia requires comprehensive medical treatment and supervision. The most important self-help measure consists of regularly adapting the medication and physiotherapy therapy to the current state of health of the patient. In this way, the progress of treatment can be optimized and, in the long term, the quality of life and well-being of the person affected can be improved.

Provided a good early support with physiotherapeutic and psychomotor procedures as well as occupational therapy measures, there is the prospect of a normalization of the movement behavior. However, the patient must perform daily exercises to strengthen the muscles. Accompanying this is a change or adaptation of the habits displayed. Exercise and a healthy and balanced diet are important cornerstones of treating hypotonia.

In addition, the doctor will recommend a therapeutic consultation to the patient. Talking to a specialist, the many problems associated with hypotonia can be discussed. If desired, the therapist can also establish contact with other affected persons or refer the patient to a self-help group. Regular use of the prescribed medication is just as important. An optimally adjusted medication reduces the typical pain and thus also prevents any subsequent diseases such as premature joint wear or bad posture.

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