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Fifteen-minute consultation: A clinical approach to the management of the child with hypertonia
  1. Daniel E Lumsden,
  2. Jill Cadwgan
  1. Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas’ NHS Foundation Trust, London, UK
  1. Correspondence to Dr Daniel E Lumsden, Paediatric Neurosciences, Guy's and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK; daniel.lumsden{at}


Elevated tone (hypertonia) is a common problem seen in the paediatric clinic. For most children and young people, hypertonia is just one aspect of a broader disorder of movement and posture. This paper describes a clinical approach to the management of hypertonia in children, considering the contribution of high tone to the functional problems experienced by the child, the potential adverse effects of reducing tone, side effects of the intervention and the importance of setting objectives/goals for intervention which can be measured at follow-up. We describe this as the ‘MOTOR’ approach and provide some examples of how it can be used in practice.

  • neurodisability
  • neurology

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  • Contributors Both authors equally contributed to this manuscript, conceiving the idea jointly and preparing the first and subsequent drafts of the manuscript together.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.