Hypertonia in Babies – What is it, Top Causes and Treatments

Try pinching your bicep or calf muscle when it is in a relaxed state. The firmness you feel is the muscle tone. When there is too much of this muscle tone, the movements will be very stiff and more robot-like. The excess muscle tone prevents the limbs from moving freely and fluidly as they should.

Hypertonia can affect many newborns and infants. Hypertonia will interfere with a baby’s physical development and can delay their milestones. Babies with hypertonia can face difficulty in walking, reaching, grabbing things, or even eating.

Sometimes, hypertonia can also develop at a later stage due to various reasons. If you notice your baby’s limbs to be very stiff when you try to move them, it could be hypertonia or just a strong baby refusing to budge.

Types of Hypertonia in Babies

Hypertonia can be classified into two types.

1. Spastic Hypertonia

In this type, the baby will have sudden and uncontrollable muscle spasms. The spasms can affect one or multiple parts of the body. This usually occurs due to an injury to the spinal cord or the brain. It can also be a symptom of cerebral palsy.

2. Dystonic Hypertonia

In this type, the muscles are rigid, and affect one’s flexibility. The muscles are unable to stretch properly, which in turn will affect the posture. It is usually a symptom of Parkinson’s disease.

Top Common Causes of Hypertonia in Babies

Hypertonia in babies occurs when there is damage to the part of the brain that is responsible for controlling movements and sending signals to various body parts. Such an issue can be present from birth or develop at a later stage. Some of the most common reasons for hypertonia in babies are

1. Central Nervous System Damage

An injury to the baby’s central nervous system during pregnancy or after delivery can cause hypertonia. The damage to the nervous system will disturb its communication with the motor pathways, thus affecting muscle tone and control.

2. Premature Birth

A baby born prematurely is at risk of developmental issues like cerebral palsy, which can lead to hypertonia.

[Read : What is Premature Delivery]

3. Oxygen Deprivation

When the baby’s brain does not get sufficient oxygen during pregnancy or labor, it can lead to oxygen deprivation. The lack of sufficient oxygen can cause several damages including hypertonia.

4. Infection

If the pregnant mother contracts a serious infection, it can spread to the fetus and affect the baby’s brain development. It can lead to hypertonia by affecting the baby’s nervous system.

5. Jaundice

Jaundice in newborns is very common. However, if jaundice goes untreated, it can damage the baby’s brain and lead to hypertonia among many other issues.

6. Poisoning

Heavy metal poisoning during pregnancy can be toxic to the fetus, thus affecting brain development. This in turn can lead to hypertonia.

7. Injury

When the part of the brain responsible for movement and control is hurt, it can cause hypertonia. This is not present at birth and can develop at any stage.

8. Neural Abnormalities

Neurodegenerative disorders or neurodevelopmental abnormalities like multiple sclerosis, or cerebral palsy can lead to hypertonia.

Symptoms of Hypertonia in Babies

Symptoms of hypertonia can be present right from the time of birth. Sometimes, you can notice them a little later, as the baby starts developing and moving. Some common symptoms of hypertonia in babies are

• Resistance when you try to move their hands and legs
• Excess muscle tone
• Difficulty in meeting physical milestones
• Unable to balance and walk or move
• Stiffness in joints – hands, legs, or neck
• Sudden jerks or twitches in their limbs

Diagnosing Hypertonia in Babies

Doctors always check a newborn thoroughly before passing them on to the parents. During this initial check, if the doctor feels excess muscle tone, they will conduct further tests to confirm a hypertonia diagnosis.

Since hypertonia can occur at any age, the diagnosis method can vary. Generally, hypertonia in babies is diagnosed before they turn 2 years old. If they have an underlying condition or injure themselves, then hypertonia can show up at that stage too.

To confirm a hypertonia diagnosis in babies, doctors will do the following:

• Observe the baby’s balance and coordination as they walk and perform other activities
• Let them play and handle things to assess their grasp, ability to sit up, grab items and move their limbs
• Check the nerve function and reflexes
• Physical examination of the entire body
• Review family medical history
• Check for any pregnancy complications.

Some of the tests a doctor will take to confirm a hypertonia diagnosis in babies are:

• MRI or a CT scan to get a close-up image of the body parts with complaints or concerns.
• Electromyograms to assess how the muscles and nerves are functioning.

Risk Factors For Hypertonia in Babies

So, how and why does hypertonia affect only some babies? While it can be a genetic transformation, in many cases, a baby is at a higher risk of hypertonia, in the following cases.

• Birth injury during the movement into the birth canal or during assisted delivery
• Lack of oxygen supply while in labor
• Certain conditions affecting nervous system and how the nerves communicate
• Injury to the central nervous system during labor or soon after birth
• Problem in the fetal brain formation
• Occurrence of stroke or tumor.
• Babies with cerebral palsy or multiple sclerosis can exhibit hypertonia as a symptom.

Treatment Options For Hypertonia in Babies

Hypertonia treatment usually involves medications and therapy that aims at relaxing the muscles. Medications can be oral, in the form of tablets, or injections. If the muscle spasms affect just one part of the body and have no impact on other areas, the injections can help control just that area.

Medications and physical therapy can differ from case to case. If there is an underlying condition leading to hypertonia, your doctor will treat that condition first. Once that is under control, they may start medications or treatment for hypertonia.
Regular exercises within limits, medications, and physical therapy can help bring hypertonia under control. The limits and extents will differ from case to case, depending on the intensity of hypertonia.

Physiotherapy for hypertonia will usually involve stretching the affected muscles and postural management as tight muscles will affect the posture. Exercises will target facilitating movement in the affected areas.

Hypertonia is a chronic condition. There is no permanent cure for it. Treatment can

• Reduce symptoms slowly
• Improve range of motion
• Help use of limbs more efficiently
• Manage pain and push limits
• Stretch stiff parts and joints
• Teach to contract and relax muscles in the correct way
• Teach relaxation techniques you can use for various parts of the body
• Strengthen muscles and joints.

When to See a Doctor?

Every parent wants to ensure their child is safe and healthy at all times. While some parents may rush to the doctor at the drop of a hat, some may hesitate to go. Such parents prefer to give it time to see if the symptoms decrease and the condition improves without any interference.

However, hypertonia is not a condition that can resolve on its own. If your baby has hypertonia, they need professional help to improve their movement and quality of life.

Here are some instances when visiting a doctor is important

• Your baby takes a fall and hurts their had badly
• You notice sudden changes in your baby’s range of movements
• Baby keeps crying, especially when you touch or hold their limbs
• You notice sudden twitches or spasms in your baby, like never before
• Your baby’s balance is off
• If your baby has started moving, their balance seems a little off lately.

All the above instances are common with every baby. Babies stiffen their joints and limbs, resist when you try to clothe them, suddenly jerk their hands without control, and even take their own time to meet a milestone. If you notice the above happening frequently, you should consult your doctor to rule out hypertonia.

Your baby could be just normal, doing normal baby things. So, don’t rush to self-diagnose. Let the professionals test and give you their expert opinion.

Hypertonia in babies is not very common. With timely treatment and medications, hypertonia in babies can improve. With physical therapy, you can help your baby achieve milestones and improve the range of movements. In most cases, hypertonia can be permanent. So, it requires a lot of patience and time from the parents’ end, to help the baby lead a close to normal life.

FAQ’s

1. Is Hypertonia a Genetic Disorder?

Hypertonia can be present at birth, caused by a dominant gene. However, it can also be due to an injury during the delivery or soon after birth. In such cases, it is not a genetically transmitted condition.

2. Does Hypertonia go Away While Sleeping?

The muscles and reflexes relax with sleep. The muscle tone is low or sometimes even absent when asleep. So, your baby may not feel stiff or react with exaggerated movements when they are asleep. Hypertonia is a condition that can slowly decrease with age or treatment.

3. Can Babies With Hypertonia Walk?

Yes, babies with hypertonia can walk. While severe hypertonia can restrict their range of motion, therapy, and medications can help control the situation. Some babies may find it challenging to bend their legs and balance their weight as they start walking. It can improve in some cases.

4. Is Hypertonia a Birth Injury?

Hypertonia can be a genetic disorder, birth injury, or an injury later in life. Any injury near the brain, cerebral palsy, or multiple sclerosis can affect the way the brain communicates with the rest of the body, including the muscles. Hypertonia can also be a genetic condition discovered very late.

Read Also: Hypotonia in Babies – Signs, Causes, Diagnosis and Treatment