Abstract
Objective: The aim of this study was to determine the diagnostic profile of infants with hypotonia and to analyze the necessity of an algorithm in the diagnostic process.
Material and Methods: Fifty-three patients admitted with the complaint of hypotonia were included in the study. The hypotonic infants were divided into two groups: central and peripheral hypotonia. An algorithm containing six steps was constructed with the analysis of clinical data and results of investigations.
Results: Thirty-eight infants had central hypotonia and 15 had peripheral hypotonia. Through a careful medical history and physical examination, a diagnosis was made in 57.8% of the patients with hypotonia by a simple karyotype analysis and cranial MRI. The neurometabolic diseases were diagnosed with further investigations. Step 1 (clinical data and physical examination) and Step 2 (cranial CT, MRI) provided the diagnosis of 21 patients. Step 3 (literature search with dysmorphic findings) and Step 4 (karyotype analysis) contributed to the diagnosis of 6 patients. The diagnosis required biochemical tests in Step 5 in 15 percent of the patients. The Step 6 tests (CK, EMG, DNA analysis for SMA and CMD, muscle biopsy) were diagnostic for 7 patients. The remaining nine patients could not be diagnosed.
Conclusion: An algorithm would be useful for the systematic evaluation of hypotonic infants to prevent unnecessary diagnostic procedures
Keywords: Algorithm, Differential diagnosis, Hypotonia, Infant
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