Hypotonic Cerebral palsy
In this variety tone in body are too less so they cannot maintain posture and balance. Most of the time presentation can change into other variety like athetoid / spastic variety. Outcomes are not satisfactory in persistent hypotonia. These children need good therapy, brace and supportive measure. In these children hypothyroidism should be ruled out.
According to GMFCS level: Gross motor functional classification system is a 5 level clinical classification system that predict prognosis on the basis of self initiating movement ability by child. GMFCS level is fixed for every child affected with cerebral palsy & not meant for outcome assessment but usually one level shift can be seen after treatment .
Our protocol in these children is to give them maximum efficient gait as much as possible by intensive therapy, brace, walking aid and correction of torsion, deformity, contracture and muscular weakness by surgical intervention. It has been shown in last 10 years that by our protocol we were able change one level of GMFCS and increase their gait efficiency as measured by FMS score.