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X Genetic hypotonia +
Hydrocephalus
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Before we start talking

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about(X)what is
Hydrocephalus and

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what is the meaning of

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genetic hypotonia ?

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NOTE
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We ask his mother to take

a photos and videos and she

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agreed .
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Hydrocephalus ? Shunt system !

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The most common treatment for
Hydrocephalus is a condition in which excess
hydrocephalus is the surgical insertion of a
cerebrospinal fluid (CSF) builds up within the
drainage system, called a shunt. It consists

fluid-containing cavities or ventricles of the
brain. The term hydrocephalus is derived from
the Greek words "hydro" meaning water and
"Cephalus" meaning the head.
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of a long, flexible tube with a valve that
keeps fluid from the brain flowing in the
right direction and at the proper rate.

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Hypotonia
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Hypotonia is the medical term for decreased

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muscle tone. Healthy muscles are never fully
relaxed. They retain a certain amount of

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tension and stiffness (muscle tone) that can
be felt as resistance to movement. Hypotonia
can happen from damage to the brain, spinal

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cord, nerves, or muscles. The damage can be
the result of trauma, environmental factors,
or genetic, muscle, or central nervous

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system disorders. Some children with benign
congenital hypotonia have minor
developmental delays or learning

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disabilities. These disabilities may continue
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through childhood.

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 X is a 2 years old baby had

Genetic hypotonia
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 His parents found that he has

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hydrocephalus after 4 month of
premature

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 Has sever cognitive problem

 has vision problem

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 Had talipes calcaneovalgus

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deformity
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 Obese

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Treatment Goals :
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Our goals :
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Parents goals : Short term goals :

 Strengthen to all his muscles

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They  Improve balance
 Use his trunk and neck
want  Increase sensitivity

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him to Long term goals :

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be  To start using his limbs
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 Crawling
normal  Walking with walker

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MMT (BEFORE He started a daily sessions when he

treatment)
5\? __ came before 6 month ( in July 2021 )
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5\2 Trunk
)F\E\R\LR( Then he start to received 1 hour \ 3
sessions per week after one month
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5\2 Neck
)F\E\R\LB( of starting the sessions .
5\2 Shoulder L+R (F\E\
AB\AD\ExR\InR)
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5\2 Elbow L+R

Because of his cognitive problems
)F\E( the results is so slow, and we
5\2 Wrist L+R repetition the exercises a lot .

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)F\E\Pro\Sup\RD\UD(
5\2 Hip L+R And because of his low immunity we
)F\E\Ab\Add\ExR\InR(

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5\2 knee L+R
stopped 1 week to 2 weeks every
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)F\E( while of time so that’s makes the

5\2 Ankle L+R good result more slowly .

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)DF\PF\Inv\Evr(
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Treatment plan :
When we started Omran
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was like
1 month old baby just lying
Balance on his back .
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We P
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T
O
O
N worked W
E
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He started the therapy when

E
on R he was year and half old .

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Family
education

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First 2 months .
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Tone management (deep joint

approximation (neck ,upper and ,
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trunk and lower)

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 Neck strength and trunk control

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 Muscles strength (upper and

lower)
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 Positioning and Handling

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Second 2 months :
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 Appreciation (upper and lower) for

joint sensation
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 Muscles strength (upper and lower)

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 Weight bearing

 Balance
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 Positioning
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Therd 2 months :
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 Appreciation (upper and lower) for

joint sensation
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 Muscles strength (upper and lower)

 Weight bearing
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 Balance
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 Positioning
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MMT (before MMT (AFTER

treatment)
5\? __ treatment)
5\? __
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5\2 Trunk 5\4 Trunk

)F\E\R\LR( )F\E\R\LR(
EXPLAIN

5\2 Neck 5\4 Neck

)F\E\R\LB( )F\E\R\LB(
5\2 Shoulder L+R (F\E\ 5\3- Shoulder L+R (F\E\
AB\AD\ExR\InR) AB\AD\ExR\InR)
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5\2 Elbow L+R 5\3- Elbow L+R

)F\E( )F\E(
5\2 Wrist L+R 5\2 Wrist L+R
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)F\E\Pro\Sup\RD\UD( )F\E\Pro\Sup\RD\UD(
5\2 Hip L+R 5\3 Hip L+R
)F\E\Ab\Add\ExR\InR( )F\E\Ab\Add\ExR\InR(
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5\2 knee L+R 5\3 knee L+R

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)F\E( )F\E(
5\2 Ankle L+R 5\2 Ankle L+R

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)DF\PF\Inv\Evr( )DF\PF\Inv\Evr(
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