Rare diseases · Sign or symptom
Hypotonia
Low muscle tone
HP:0001252
What it means
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Hypotonia can be caused by abnormalities of the central nervous system, any element of the motor unit (including the lower motoneuron), or both. Hypotonia is not a specific diagnosis, but can be observed in hundreds of genetic and other diseases. The first distinction to make when assessing a child with hypotonia is whether decreased muscle tone is a result of an abnormality of the central nervous system (CNS), peripheral neuromuscular system, or a combined abnormality involving both. Clinical findings suggestive of an abnormality of the CNS may include hyperreflexia, cognitive developmental delay, and seizures. In contrast, physical findings pointing towards a neuromuscular origin may include weakness, lack of antigravity movements, muscle atrophy, fasciculations, and/or diminished reflexes, most often in the context of normal cognitive function. The HPO term does not distinguish between these etiologies. Additional HPO terms should be used as required to describe associated features.
Rare diseases that can present with this565
Always100%
4Very common80–99%
76- 14q22q23microdeletion syndrome
- 15q11q13microduplication syndrome
- 17p11.2microduplication syndrome
- 17p13.3microduplication syndrome
- 1p36deletion syndrome
- 1q44microdeletion syndrome
- 20q13.33microdeletion syndrome
- 22q11.2deletion syndrome
- 2p21microdeletion syndrome
- 2q37microdeletion syndrome
- 3C syndrome
- 3-methylcrotonyl-CoA carboxylase deficiency
- 3-methylglutaconic aciduria type 4
- 3-methylglutaconic aciduria type 9
- 3q13microdeletion syndrome
- 49,XXXXY syndrome
- 49,XYYYY syndrome
- 4q21microdeletion syndrome
- 5q14.3microdeletion syndrome
- 6p22microdeletion syndrome
- 8q12microduplication syndrome
- 8q21.11microdeletion syndrome
- Adrenomyodystrophy
- AHDC1-related intellectual disability-obstructive sleep apnea-mild dysmorphism syndrome
- ALG1-CDG
- ALG3-CDG
- ALG8-CDG
- Alopecia-intellectual disability syndrome
- Alpha-N-acetylgalactosaminidase deficiency
- Alpha-N-acetylgalactosaminidase deficiency type 1
- Arthrogryposis multiplex congenita-whistling face syndrome
- Athyreosis
- Autosomal dominant congenital benign spinal muscular atrophy
- Autosomal recessive frontotemporal pachygyria
- B4GALT7-related spondylodysplastic Ehlers-Danlos syndrome
- Blepharophimosis-intellectual disability syndrome, SBBYS type
- Borjeson-Forssman-Lehmann syndrome
- Brain malformation-congenital heart disease-postaxial polydactyly syndrome
- CAMOS syndrome
- Carbamoyl-phosphate synthetase 1 deficiency
- Cardiofaciocutaneous syndrome
- Cardiomyopathy-hypotonia-lactic acidosis syndrome
- Carey-Fineman-Ziter syndrome
- Carnitine palmitoyl transferase 1A deficiency
- Cartilage-hair hypoplasia
- Cerebellar hypoplasia-tapetoretinal degeneration syndrome
- Coffin-Lowry syndrome
- COFS syndrome
- COG7-CDG
- Cohen syndrome
- Combined immunodeficiency due to CRAC channel dysfunction
- Congenital fiber-type disproportion myopathy
- Congenital lactic acidosis, Saguenay-Lac-Saint-Jean type
- Congenital muscular dystrophy, Fukuyama type
- Congenital muscular dystrophy-infantile cataract-hypogonadism syndrome
- Cryptorchidism-arachnodactyly-intellectual disability syndrome
- Cutaneous mastocytosis-deafness-microtia syndrome
- Distal deletion 19p syndrome
- Distal deletion 9p syndrome
- Distal monosomy 7q36 syndrome
- Down syndrome
- Dysequilibrium syndrome
- Dysmorphism-cleft palate-loose skin syndrome
- Early-onset epilepsy-intellectual disability-brain anomalies syndrome
- Encephalopathy due to prosaposin deficiency
- Fetal methylmercury syndrome
- FOXG1 syndrome
- FOXG1 syndrome due to 14q12 microdeletion
- Free sialic acid storage disease
- Fried syndrome
- Fryns-Smeets-Thiry syndrome
- Galactose epimerase deficiency
- Gamma-aminobutyric acid transaminase deficiency
- German syndrome
- Glycine encephalopathy
- Glycogen storage disease due to glucose-6-phosphatase deficiency
The range is how often this sign appears among people diagnosed with each disease — it is not a probability of having any of them. Many of these signs also occur in common, non-rare conditions, and Orphanet separately records 2 diseases where this sign is specifically absent. A sign on this page is a conversation to have with a clinician, not a conclusion.
Part of the broader category
Also called: Central hypotonia · Low or weak muscle tone · Muscle hypotonia · Muscular hypotonia · Peripheral hypotonia
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Start free with EleplanThis page uses the Human Phenotype Ontology (2026-06-23) — Human Phenotype Ontology Consortium, hpo.jax.org. Disease associations from Orphanet (INSERM), CC BY 4.0. Content is educational and is not medical advice.