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. 2022 Jul;181(7):2771-2778.
doi: 10.1007/s00431-022-04476-x. Epub 2022 May 4.

Assessing floppy infants: a new module

Costanza Cutrona  1   2 , Elisa Pede  1   2 , Roberto De Sanctis  1 , Giorgia Coratti  1   2 , Eloisa Tiberi  3 , Rita Luciano  3   4 , Maria Carmela Pera  1   2 , Chiara Velli  1 , Anna Capasso  1   2 , Giovanni Vento  3   4 , Domenico M Romeo  1   2 , Marika Pane  1   2 , Eugenio Mercuri  5   6
Affiliations

Assessing floppy infants: a new module

Costanza Cutrona et al. Eur J Pediatr. 2022 Jul.

Abstract

Our aim was to develop a new module for assessing the floppy infant, to describe the application of the module in a cohort of low-risk newborns and piloting the module in a cohort of floppy infants. The module was applied to a cohort of 143 low-risk newborns and piloted in in a cohort of 24 floppy infants. The new add-on module includes a neurological section and provides a section for recording information obtained by physical examination and antenatal history. For each item, column 1 reports abnormal findings, column 3 normal findings, and column 2 intermediate signs to be followed. Consistent with previous studies, in low-risk infants, none had definitely abnormal or mildly abnormal signs, with the exception of tendon reflexes that were not easily elicitable in 17.14% of term-born infants.

Conclusion: Our study suggest that the module can be easily used in a clinical setting as an add-on to the regular neonatal neurological examination in newborns identified as hypotonic on routine examination. Larger cohorts are needed to establish the accuracy of the prognostic value of the module in the differential diagnosis of floppy infant.

What is known: • Hypotonia is one of the key signs in newborns with neuromuscular disorders and can be associated with a wide range of other conditions (central nervous system involvement, genetic and metabolic diseases). • Weakness or/and contractures can identify infants with a neuromuscular disorder and help in the differential diagnosis of floppy infants.

What is new: • To date, this is the first attempt to develop and apply a specific neurological module for the assessment of the floppy infant. • The module can be used in a routine clinical setting as an add-on to the regular neurological examination and has potential to differentiate the floppy infants from the low-risk infants.

Keywords: Examination; Floppy; Hypotonia; Neonate; Weakness.

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Conflict of interest statement

De Sanctis R reports personal fees from Biogen S.R.L. Italia, AveXis, and Novartis outside the submitted work; Coratti G reports personal fees from Biogen S.R.L. Italia, Roche, Genesis Pharma, AveXis, Novartis, and Biologix, outside the submitted work; Pera MC reports personal fees from Roche outside the submitted work; Pane M reports personal fees from Biogen S.R.L., PTC, AveXis, Novartis, and Sarepta, outside the submitted work; Mercuri E reports personal fees from AveXis, Novaris, Roche, Biogen S.R.L., PTC Therapeutics, Sarepta, and Santhera, outside the submitted work; Cutrona C, Pede E, Tiberi E, Luciano R, Velli C, Capasso A, Vento G, and Romeo DM have nothing to disclose.

Figures

Fig. 1
Fig. 1
Proforma for the assessment of the floppy infant
See this image and copyright information in PMC

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