Movement disorders in newborns and infants are fundamentally different from those in older children and adults. Brain damage in the early stages of ontogenesis in most cases causes generalized changes, which makes topical diagnosis extremely difficult. More often we can only talk about the predominant defeat of those or other parts of the brain.
Pyramidal and extrapyramidal disorders in children
Differential diagnosis in young children between pyramidal and extrapyramidal disorders (symptoms) causes some difficulties. The main characteristics in the diagnosis of movement disorders in the first year of life are muscle tone and reflex activity. Symptoms of changes in muscle tone may differ at different ages in a child. This is especially true for the first and second age periods (up to 3 months), when the child has physiological hypertension.
Changes in muscle tone are manifested by muscle hypotension, dystonia, and hypertension.
SYNDROME OF MUSCLE HYPOTONIA, HYPOTONUS IN A CHILD, IN CHILDREN, IN THE BREAST, IN NEWBORNS
Muscular hypotension syndrome, causes, symptoms, signs of hypotonus
The syndrome of muscle hypotension is characterized by a decrease in resistance to passive movements and an increase in their volume. Spontaneous and voluntary motor activity is limited, tendon reflexes can be normal, increased, decreased or absent depending on the level of damage to the nervous system. Muscular hypotension is one of the most commonly found syndromes in newborns and infants . It can be expressed from birth, as is the case with congenital forms of neuromuscular diseases, asphyxia, intracranial and spinal birth trauma, damage to the peripheral nervous system, some hereditary metabolic disorders, in children with congenital or early acquired dementia, chromosomal syndromes. At the same time, hypotension may appear or become more pronounced at any age period if the clinical symptoms of the disease begin several months after birth or are progressive in nature. Hypotension, expressed from birth, can transform into normotonia , dystonia, hypertension, or remain the leading symptom throughout the first year of life. The severity of the clinical manifestations of muscle hypotension varies from a slight decrease in resistance to passive movements to complete atony and the absence of active movements.
Retardation and retardation of psychomotor development with muscle hypotension, hypotonia
If the syndrome of muscle hypotension is mild and does not combine with other neurological disorders, it either does not affect the age-related development of the child, or causes a delay in motor development, more often in the second half of life. The lag is uneven, more complex motor functions are delayed, requiring coordinated activity of many muscle groups for their implementation. So, a planted child sits for 9 months, but cannot sit on his own. These children begin to walk later and the supported walking period is delayed for a long time. Muscle hypotension can be limited to one limb (traumatic paresis of the legs, obstetric paresis of the hand). In these cases, the delay will be partial.
Delay in psycho- motor development in muscle hypotension in children
The pronounced muscle hypotension syndrome has a significant effect on the delay in motor development . Thus, motor skills in the congenital form of Werdnig – Hoffmann spinal amyotrophy in a child of 9 to 10 months may correspond to the age of 2 to 3 months. The delay in motor development, in turn, becomes the cause of the peculiarities of the formation of mental functions. For example, the lack of the possibility of voluntary gripping of an object leads to underdevelopment of visual-motor coordination and manipulative activity. Since muscle hypotonia is often combined with other neurological disorders (convulsions, hydrocephalus, cranial nerve paresis, congenital paralysis of the facial nerve ), the latter can modify the nature of developmental delay, determined by hypotension as such. The quality of the muscle hypotension syndrome itself and its effect on developmental delay will vary with the disease. With convulsions, congenital or early acquired dementia, not so much hypotension as delayed mental development is the reason for the lag in motor, motor development.