The phenomenon that we will discuss in this material is not considered an independent disease. The syndrome of a lethargic child is a sign of a number of pathologies and diseases diagnosed in newborns. In the article we will analyze the characteristic of the syndrome, its main symptoms, possible causes, diagnostic and treatment possibilities.
What is it?
A flaccid child syndrome is congenital muscle weakness (hypotension), the origin of which may be different. The reason is pathologies and diseases of various etiologies, which are characterized by a decrease in muscle tone.
Disorders of the sluggish child are often accompanied by disorders such as dysfunction of the swallowing and respiratory systems, impaired consciousness, and convulsive reactions. We have already noted that it is not an independent disease. However, its isolation is necessary for the reason that the complex of therapeutic measures for various diseases-causes is almost the same.
The term "flaccid child syndrome" was proposed in 1958 by the neuropathologist Greenfield (USA). However, studies of this condition of newborns have been conducted since the beginning of the 20th century.
First of all, the pediatrician diagnoses the condition by the characteristic lifeless pose of the baby. However, muscle hypotension to determine the diagnosis must be confirmed by instrumental examination. To clarify the causes of the state of the art, MRI, genetic mapping, and laboratory tests are used.
The directions of therapy are symptomatic and pathogenetic. Artificial ventilation, drugs of neurometabolic action are widely used.
Today, the syndrome is considered one of the urgent problems of world pediatrics. Identified more than 80 diseases in which it can occur. What is sad: the overwhelming majority of them have disappointing forecasts confirming a high percentage of deaths.
The most common causes of the condition
As statistics show, diffuse hypotension (general muscle weakness) in 3/4 of the cases causes the following:
- Perinatal ischemia.
- Perinatal hypoxia.
- Muscular spinal dystrophies.
- Dysgenetic syndrome.
Classification of Concomitant Diseases
Syndrome of a sluggish child may be a consequence of a disease belonging to one of the following groups.
Neuromuscular pathology:
- Congenital myopathy
- Congenital muscular dystrophy.
- Cytochrome C oxidase deficiency.
- Spinal muscular infantile dystrophy.
- Myotonic congenital myopathy.
- Pompe disease.
- Mitochondrial DNA Depletion Syndrome.
Disturbances in the central or peripheral nervous system:
- Intoxication.
- Sepsis.
- Disorders of the transmission of nerve impulses.
- Down Syndrome.
- Perinatal asphyxia.
- Intracranial hemorrhage.
- Syndrome associated with impaired body weight gain.
- Congenital form of hypothyroidism.
- Prader-Willi Syndrome.
- Malformations, spinal cord injuries, other birth injuries.
Syndrome of a sluggish child can also be a consequence of the following pathologies and dysfunctions:
- Central acquired hypotension.
- The defeat of the cells of the anterior horn.
- Connective tissue diseases.
- Lesions of the neuromuscular synapses.
The impact of maternal health
Does the condition of the future mother somehow affect the birth of a baby with a sluggish baby syndrome? Experts during the research noted the following:
- In some small patients, mothers suffered from neuromuscular pathologies. In particular, muscle myotonic dystrophy. The disease limits the natural movement of the fetus in the womb.
- Some mothers were diagnosed with ulcerative colitis. This disease also limits the movement of the embryo.
- Reception during pregnancy of alcoholic beverages, narcotic substances, anticonvulsants also in some cases became the cause of the birth of a child with diffuse hypotension.
Symptomatology
Signs of a syndrome of a lethargic child become noticeable already in the first days (and sometimes in the first hours) of birth. The specific symptoms will depend on the disease, pathology, which is accompanied by hypotension (muscle weakness). However, there are also general symptoms of a flaccid baby syndrome:
- The characteristic "frog pose". The child’s legs will be wide apart and bent at the knees, while the feet will “look” at each other with the plantar surface.
- During the examination by the doctor, excessive articular mobility is observed. It causes reduced muscle resistance.
- In some cases, in the distal extremities of the limbs, muscle tone remains elevated. If hypotension is general, then the cams of the newborn are compressed.
- If the syndrome is caused by an infectious, traumatic brain injury, convulsions, loss of consciousness may be present. The decrease in muscle tone here is temporary, giving way to hypertonicity.
- With congenital myopathy and muscular dystrophy, hypotension, on the contrary, will only progress. It begins with muscle weakness of the extremities, passing to the respiratory and swallowing systems. It is difficult for a child to eat, he is diagnosed with shortness of breath and apnea attacks.
Diagnostics
Syndrome of a sluggish child (the photo in the article illustrates the features of a similar condition of a newborn) is determined by a specialist in the early days and even hours of life. First of all, according to the characteristic appearance, the pose of the baby.
The second stage of diagnosis is neurological tests. This is traction (stretching) for the upper limbs in the supine position, vertical, horizontal suspension. With the syndrome of a sluggish child, the baby's head hangs during these manipulations, the tone in the arms and legs is visually reduced.
The following diagnostic procedures are also performed:
- Electroneuromyography. Examination helps to identify the peripheral origin of the syndrome.
- MRI Detection of atrophy in some parts of the brain.
- Laboratory diagnostics. Confirms / refutes the infectious cause of the syndrome.
- Examination of the heart.
- Genetic mapping. Identifies / excludes the cause of the syndrome - chromosomal pathologies. Such as metabolic hereditary dysfunction, Down's disease.
Therapies
Methods for the specific treatment of the flaccid child syndrome do not exist today. In this condition, neurometabolic agents, energy tonics are effective. But they can guarantee only a slight temporary improvement in the condition of the baby.
Many children suffering from a symptom require oxygen support, mechanical ventilation.
Forecasts of specialists
The development of diseases that cause, among other things, the syndrome of a lethargic child, can be both rapid and slow. However, their course will, unfortunately, be irreversible.
From all that has been said, it can be revealed that the prognosis is rather unfavorable. Among children with this syndrome, mortality is high in the first months and years of life. There are several reasons for a possible fatal outcome:
- Weakness of the respiratory muscles.
- Metabolic disorders.
- Septic complications and so on.
What is flaccid baby syndrome? This is a manifestation of hypotension, which first affects the limbs of the newborn, and then becomes general, diffuse. The condition is noted for many diseases of various etiologies in children. Unfortunately, to date, the predictions of cure are disappointing. With this pathology, high mortality of patients is noted.