Main clinical features
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congenital hypotonia that progresses to spasticity with severe psychomotor delays
mental retardation, with spastic paraplegia, ataxia, absent speech, abnormal thyroid function, reduced muscle mass, and delay of developmental milestones, generalized weakness manifested by excessive drooling, forward positioning of the head and neck, muscle hypoplasia, generalized muscle weakness, and limited speech
face tends to be elongated with bifrontal narrowing, and the ears are often simply formed or cupped, myopathic facies |