Main clinical features
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myopathy with lipid storage, developmental delay, speech delay, hypotonia, failure to thrive, feeding difficulties, seizures, dysmorphic features, hypoglycemic encephalopathy, microcephaly, optic atrophy, hepatomegaly and jaundice, muscular hypertonia
neonatal features including feeding difficulties, hypotonia, lethargy, hypoglycemia, dysmorphic features, brain malformations with infantile spasms and death
biochemical hallmarks are elevated levels of butyrylcarnitine (C4) as detected by acylcarnitine analysis and urinary excretion of ethylmalonic acid
should be considered in the differential diagnosis of gyral abnormality, corpus callosal hypoplasia, and infantile spasms |