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The floppy infant revisited: From bedside to genome
Gianpaolo Cicala1,2, Eugenio Mercuri1,2
1Centro Clinico NeMO, Fondazione A. Policlinico Gemelli, IRCCS, Rome, Italy.
Insights
Diagnosing neonatal hypotonia requires a structured approach, combining clinical assessment with advanced genomic tools for faster, accurate identification of causes and enabling early intervention for better outcomes.
Area of Science:
- Neonatology
- Genetics
- Pediatric Neurology
Background:
- Neonatal hypotonia poses a significant diagnostic challenge.
- Timely evaluation is crucial for identifying underlying causes and initiating appropriate care.
Purpose of the Study:
- To review recent advances in diagnosing and managing early-onset neonatal hypotonia.
- To highlight the integration of clinical assessment and genetic technologies.
Main Methods:
- A narrative review based on a targeted PubMed search and clinical guidelines.
- Focused on diagnostic and management strategies, including genetic tools and advanced therapies.
Main Results:
- Structured clinical assessment is fundamental, guiding the selection of investigations.
- Rapid genomic technologies (exome/genome sequencing) have substantially increased diagnostic yield.
- Early detection of treatable conditions facilitates timely intervention.
Conclusions:
- Integrating bedside assessment with genomic tools accelerates diagnosis and improves patient outcomes.
- Early and accurate diagnosis is key to effective management of neonatal hypotonia.
Abstract:
Neonatal hypotonia presents a complex diagnostic challenge that requires timely, structured evaluation to identify underlying causes and initiate appropriate care. A narrative review was conducted based on a targeted search of PubMed and major clinical guidelines, focusing on recent advances in the diagnosis of early-onset hypotonia, spanning from clinical to new genetic tools, while also exploring different aspects of management, including new advanced therapies. A structured clinical assessment remains fundamental, especially where access to advanced investigations is limited, and can help the clinician to select the appropriate investigations to achieve a definite diagnosis. Rapid genomic technologies, including exome and genome sequencing, have significantly improved diagnostic yield. Early detection of treatable conditions can enable timely initiation of intervention. Integrating bedside assessment with genomic tools can accelerate diagnosis and improve outcomes, thus facilitating early intervention.
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