Muscular hypotonia: What to do to cure it?

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Muscles weakened, movement disorders, lack of coordination of gestures… sometimes our muscles no longer react normally to orders given by the nervous system. This is what usually happens in case ofhypotonia muscular. This is a syndrome and not a pathology. It can be present at any age, in babies as in the adults.

Want to know more ? Find out in this article everything you need to know about hypotonia muscular : definition, causes, clinical presentation and treatments.

What is muscle hypotonia?

Definition

Hypotonia designates a decrease du tone muscular. She translates a decrease muscle strength and motor deficit. This can be characterized by either no movement or less response compared to passive joint movements (movements that normally do not require effort).

La decrease in the force of contraction can touch the muscles smooth and muscles streaked.

The different types of muscle hypotonia

Like all muscles can suffer hypotonia, we then distinguish:

  • axial type hypotonia: when the muscles head and trunk affected;
  • pyelic hypotonia: at the level of kidneys ;
  • ocular hypotonia: intraocular pressure drops and vision is blurred;
  • hypotonia at the infant : muscle relaxation is observed in the baby. He is unable to keep his joints bent and is slow to acquire motor skills such as head holding and sitting posture.

Pathophysiology

La contraction muscular insurance takes place when intention originates in the brain. In the motor cortex, nerve cells (neurons) transmit nerve impulses to the cells of the spinal cord. These in turn send information back to the target neuromuscular junctions. The affected muscles respond by performing the desired movement.

Taking into account this mechanism of voluntary muscle contraction, the appearance of hypotonia muscular can be explained in different ways. It can be associated with disorders within nerve structures, Has muscle disorders or to a particular pathology.

What causes muscle weakness?

The etiology of a decrease du tone muscular varies according to the location of the lesion and the muscles affected. 

Neurological causes

If thehypotonia muscular is related to a neurological disorder, the transmission of nerve impulses that control the muscles is not carried out correctly. The source of the problem may be in the central nervous system or the peripheral nervous system. There are several possible causes.

  • Infringement du cerebellum (cerebellar disorders): it results in a lack of coordination of movements or ataxia. The power, the direction of the movements, the maintenance of the posture and the balance are then disturbed.
  • A achievement of vestibule inner ear : the cavity involved in the balance of the body. This is a rare case.
  • A cerebrovascular accident (CVA) : hypotonia then precedes hemiplegia.
  • Other types of neuropathies : ductal (case of carpal tunnel syndrome), traumatic or immune-mediated.
  • A syndrome pyramid: damage to the pyramidal pathway responsible for controlling voluntary movements and regulating muscle tone.
  • Personalized polyneuritis: peripheral nerve damage.

 

Hypotonia can also be linked to other symptoms of neuropathies such as obnubilation, stupor, coma or even physiological sleep.

Myogenic causes (muscle involvement)

Hypotonia may derive from some anomalies et unrest du muscular system. This can happen in one of the following situations:

  • inactivity which can lead to a atrophy muscular : it is often encountered in the elderly;
  • immobilization widespread (in case of intensive care or resuscitation): this can cause muscle wasting;
  • the myopathies linked to alcoholism, deficiency en Potassium, taking cortisone (myopathy cortisone), Etc.

Other causes

Here are other causes that explain muscle weakness.

  • Sclerosis.
  • Root compressions as in the case of herniated disc.
  • The spinal compressions (epidural metastasis…).
  • Drug causes: the effects of anesthetics and neuroleptics. In infants, hypotonia may be caused by the mother taking anti-anxiety medications during pregnancy.
  • Genetic causes such as trisomy, spinal muscular atrophy, Down syndrome, etc.

Clinical presentation of muscle hypotonia syndrome

On these etiologies depend the symptoms of hypotonia from which the diagnosis is made. 

Clinical signs and symptoms

Hypotonia muscular usually manifests as:

  • incomplete muscle contraction (or paresis);
  • of abnormal movements : chorea (arrhythmic, illogical, unpredictable movements of the limbs, muscles of the trunk, neck and even of the face) or hemiballismus (unilateral, non-rhythmic, rapid and involuntary movements);
  • of difficulty performing movements of daily life: holding an object, writing, standing or sitting for a long time.

This muscular weakness may be passenger (if it is linked to the occurrence of an acute pathology) or chronic. She can appear suddenly as in the case of a stroke or trauma. She can also be progressive, after several days of progression of a pathology, or even after several months as in the case of myasthenia or myopathies.

In severe cases, patients suffer from:

  • breathing difficulties (dyspnea);
  • difficulty making movements against gravity (such as lifting the head);
  • walking, chewing and speaking problems;
  • paralysis.

The diagnosis

During the consultation, the doctor first performs a examination. It collects information on symptoms, their occurrence and risk factors.

The professional continues with the in-depth examinations. They differ depending on whether the patient is an infant, a child or an adult.

In infants, the examination is limited to a analysis du tone passive (at rest) and tone active (during movements against gravity). However, Additional tests may be needed to better understand theetiology de hypotonia. To do this, the doctor often suggests blood tests and imaging exams.

At the older, un exam clinical and even a exam neurological with a QUOTE de the activity muscular (electrocardiogram) make it possible to diagnose hypotonia. In addition, the doctor can perform:

  • un testing muscular to explore the muscles in various positions (sitting, standing, squatting, etc.);
  • a survey de coordination (by the finger-nose maneuver for example);
  • un exam of reflexes;
  • the exams Additional : MRI and scanner.

A scan allows to highlight hypotonia at the level of waist.

And in case of suspicion hypotonia ocular, measure la pressure intraocular confirms the diagnosis.

Hypotonia is not to be confused with tiredness. Indeed, in fatigue, the sensation of muscle weakness does not improve and she is not not localized.

How to treat muscle hypotonia?

Where to turn?

Consult a doctor general practitioner is a good idea if any of the symptoms of hypotonia occur. However, you should know that the treatment is multidisciplinary. He sometimes requests the intervention of various health professionals:

  • pediatrician; 
  • geneticist;
  • physiotherapist ;
  • Speech Therapist ;
  • neurologist;
  • psychologist;

What are the possible treatments ?

In case hypotonia muscularit will take treat the etiology who originated it. However, it is also important to relieve the symptoms linked to this trouble

Symptomatic treatments do not immediately eliminate hypotonia muscular. On the other hand, they help the patient to adapt and vivre with. The objectives are mainly to limiter la decrease du tone muscular as well as his complications. Generally, physiotherapy, occupational therapy, speech therapy and surgery are used.

  • La physiotherapy This is the main treatment practiced in infants as well as in hypotonic adults. It consists of a series of exercises, manipulations and rehabilitation aimed at correcting difficulties, movement anomalies and coordination problems.
  • occupational therapy is useful if hypotonia is reaction to the point of being disabling. This treatment works on the patient's environment in order to help him live better in autonomy.
  • Speech therapy: to treat hypotonia full appetizer, problems de languages, chewing as well as breathing which are related to it
  • The intervention surgical si hypotonia concerns the kidneys.

In all cases, monitoring of the evolution of the patient's condition is necessary.

To conclude, hypotonia muscular does not represent a risk to the patient's life. However, in the long term, it can become a handicap, hence the importance of diagnosis, management and treatment. It is therefore essential to consult a healthcare professional if you experience any sign of weak muscle.

References

https://www.msdmanuals.com/fr/professional/troubles-neurologiques/sympt%C3%B4mes-des-troubles-neurologiques/faiblesse-musculaire

https://www.sciencedirect.com/science/article/am/pii/S1166708720302128

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