Floppy baby syndrome, in simple terms, is hypotonia during infancy. It is muscle weakness or reduced muscle tone in a baby.Now as med students we know causes of hypotonia in adults but what could cause hypotonia/Floppy Baby Syndrome in infants?
SO MANY!!!
Causes:
- Hypoxic Ischemic Encephalopathy,
- Administration of Fentanyl to the mother with baby still attached to cord.
- Inborn metabolism disorder,
- Prader-Willi syndrome,
- Kernicterus,
- Agenesis of the corpus callosum,
- Transection of the spinal cord due to breech delivery,
- Werdnig-Hoffman's disease (Infantile muscle dystrophy),
- Metachromatic leukodystrophy,
- Botulism,
- Infantile Myasthenia Gravis,
- Muscular Dystrophy,
- Metabolic Myopathies,
{Alot of fancy names. Details about it, we'll all learn it in time.}
It can also happen during Forceps delivery, when the nurses use a forceps in an inexperienced way causing hemorrhage.
- Dengue fever caused due to the ?virus spread by the Aedes mosquito, is a disease of the tropics.
- The patient presents with high fever (saddle back fever) and a prominent maculopapular rash or just macular rash.
- Muscle and joint pain, Back pain, abdominal tenderness and jaundice are some of the added symptoms.
- Retro-orbital tenderness is prominent in patients too.
- One of the most important tests to do on the patient is his platelet count to make sure the patient does not enter Dengue Hemorrhagic Fever or Dengue Shock Syndrome. Probability of DIC is very high.
- A patient who has already had dengue before must be carefully monitored because the antigen-antibody complex might precipitate increasing the chances of DIC.
- One important point is the incubation period, it is usually 5 to 7 days. So, determining where the patient was 5 to 7 days before his symptoms began is most important because the area must be quarantined or reported to the infection control department of the hospital/state.
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Hemisection of the spinal cord results in a contralateral loss of pain and thermal sensation due to spinothalamic damage, and ipsilateral loss of proprioception due to posterior column damage.
There is also an ipsilateral motor paralysis due to destruction of the corticospinal and rubrospinal tracts as well as motor neurons.
Complete transection of the spinal cord would cause a bilateral spastic paralysis, and there would be no conscious appreciation of any cutaneous or deep sensation in the area below the transection.
Posterior column syndrome would result in a bilateral loss of proprioception below the lesion, with relative preservation of pain and temperature sensation.
Syringomyelic syndrome results from a lesion of the central gray matter. Pain and temperature fibers that cross at the anterior commissure are affected, which may result in bilateral loss of these sensations over several dermatomes. However, tactile sensation is spared. The most common cause of this type of syndrome is syringomyelia. Trauma, hemorrhage, or tumors are other possible etiologies. If the lesion becomes large enough, then other spinal cord systems become affected as well.
Tabetic syndrome results from damage to proprioceptive and other dorsal root fibers. It is classically caused by syphilis. Symptoms include paresthesias, pain, and abnormalities of gait. Vibration sense is most affected.
Initially he had a bilateral spastic paraparesis and urinary urgency, but this has improved. He still has pain and thermal sensation loss on part of his left body and proprioception loss in his right foot. There is still a paralysis of the right lower extremity as well. The patient had Brown-Séquard (hemisection) syndrome .
