الفهرس 
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Abstract
A retrospective analysis was performed on 100 cases of infantile hypotonia who were admitted at the neurological unit of Pediatric department, Zagazig university hospitals during the period from 1st of February 2010 to 1st of July 2010. In our study, the central hypotonia suspected by neurological history, examination, relevant neuroimaging finding and chromosomal study in infantile hypotonia represent about 78% while peripheral hypotonia represent about 22%. There was non significant statistical relationship between gender including male and female in suspecting whether it is central or peripheral hypotonia that in central hypotonia male represent about 53,8% with male to female ratio is 1.16:1 while in peripheral hypotonia male represent about 54.5% with male to female ratio is 1.19:1 and in total study male represent about 53% with male to female ratio is 1.12:1 with (p value = 0.95). There was non significant relationship between the mean age in relation to hypotonia that the mean age in central hypotonia was 11.7 ± 5.8 months but in peripheral hypotonia, mean age was 13.5 ± 4.98 months with total mean of age for all cases of 3.3-22 months (p value = 0.18). There was significant relationship between the perinatal history and development of infantile hypotonia in which the perinatal history was relevant in 43.6 while in peripheral hypotonia perinatal history was relevant in 18.2% with total study the perinatal history was relevant in 39% ( p value = 0.03). There was non significant relationship between family history and development of infantile hypotonia that family history was apparent relevant in 30.8% of central hypotonia while in peripheral hypotonia family history was apparent relevant in 72.7% with total percentage of positive family history was 37% (p value = 0.75).
There was non significant relationship between history of motor delay and suspecting whether it is central or peripheral hypotonia that the motor delay was apparent in 72.7% of peripheral hypotonia while in central hypotonia motor delay was apparent in 84.6% with total percentage of motor delay was 83% in both type of hypotonia (p value = 0.33). There was highly significant relationship between the history of mental delay and suspecting whether it is central or peripheral hypotonia that the mental delay was apparent in 74.4% in central hypotonia while in peripheral hypotonia the mental delay was apparent in 27.3% with total percentage of mental delay was 53% in both types (p value < 0.001). There was highly significant relationship between the history of social delay and suspecting whether it is central or peripheral hypotonia that the social delay was not apparent in peripheral hypotonia while in central hypotonia social delay was apparent in 76.9% (p value < 0.001). There was highly significant relationship between the visual delay and suspecting whether it is central or peripheral hypotonia that the visual delay was not apparent in peripheral hypotonia while in central hypotonia visual delay was apparent in 76.9% (p value < 0.001) . There was non significant relationship between detecting the deep tendon reflex and suspecting whether it is central or peripheral hypotonia that the deep tendon reflex is preserved in about 33.3% of peripheral hypotonia while in central hypotonia deep tendon reflex is preserved in about 54.5% (p value = 0.07). There was highly significant relationship between detecting the development of the antigravity movement and suspecting whether it is central or peripheral hypotonia that the antigravity movement is not preserved in all cases of peripheral hypotonia while in central hypotonia the antigravity movement is preserved in about 66.7% (p value < 0.0016). There was highly significant relationship between seizures and suspecting whether it is central or peripheral hypotonia that seizures were apparent in about 84.6% of central hypotonia while in peripheral hypotonia seizures were apparent in about 18.2% of (p value < 0.001). Neuroimaging study mainly cranial MRI contributes to final diagnosis in about 51.2% of suspecting central hypotonia while peripheral hypotonia almost spinal muscle atrophy confirmed by neurological history, examination and EMG study. There was significant relationship between range of calcium level and hypotonic infants whereas range of calcium level was 7.3-10.6 mg/dl with x ± SD of 9.24 ± 1.06 in peripheral hypotonia but in central hypotonia, range of calcium level was 6.7-10.5 mg/dl with x± SD of 8.59 ± 1.09 with p value < 0.014. There was non significant relationship between phosphorus level and hypotonic infants whereas range of phosphorus level was 3.9-5.5 mg/dl) with x ± SD of 4.65 ± 0.38 in peripheral hypotonia but in central hypotonia, range of phosphorus level was 3.1-5.8 mg/dl with x ± SD of 4.74 ± 0.4 with p value of 0.37.