Clinical features
This form of the condition has the most severe clinical manifestations.
- development of vomiting and poor feeding during the first week of life, after being normal at birth.
- the child then becomes lethargic and falls into a coma over the next few days.
- there may be convulsions
- hypoglycamia may develop
On examination there is:
- increased tone, rigid muscles and severe opisthotonus, which may alternate to periods of flaccidity.
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