Paeds Vivas · growth-development-and-behaviour
Motor delay, hypotonia and the floppy infant — branching viva
Branching viva on tone versus strength, central versus peripheral localisation, SMA, botulism, maternal myotonia and disposition.
On this page & tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are in general paediatrics clinic/ward. A family presents with a floppy or motor-delayed infant. The examiner will test definitions, localisation, can't-miss pathways and counselling.
Stem
A 4-month-old is brought because she “goes through your hands” when held under the arms and is not rolling. The examiner starts with definitions, then branches into red-flag phenotypes. [1]
Continue reading
Paediatrics Fellowship Pro
You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.
References7Show ledgerHide ledger
- [1]Peredo DE, Hannibal MC The floppy infant: evaluation of hypotonia. Pediatrics in review, 2009.PMID 19726697
- [2]Bodensteiner JB The evaluation of the hypotonic infant. Seminars in pediatric neurology, 2008.PMID 18342256
- [9]Finkel RS, Mercuri E, Darras BT Nusinersen versus Sham Control in Infantile-Onset Spinal Muscular Atrophy. The New England journal of medicine, 2017.PMID 29091570
- [10]Mendell JR, Al-Zaidy S, Shell R Single-Dose Gene-Replacement Therapy for Spinal Muscular Atrophy. The New England journal of medicine, 2017.PMID 29091557
- [16]Sarintra N, Ekdahl R, Sanders SC More Than Just a Floppy Baby: Maintaining High Clinical Suspicion of Infant Botulism. Cureus, 2026.PMID 41728439
- [17]Suzui R, Wada I, Matsubara M Undiagnosed Maternal Myotonic Dystrophy Type 1 Revealed by Congenital Myotonic Dystrophy in the Neonate. Cureus, 2026.PMID 42037975
- [5]Laverty CG Hypotonia in the Newborn Infant. Pediatric clinics of North America, 2025.PMID 40619196