CLINICAL HISTORY 10

The patient Robert Bush was born at 38 weeks via C-section. The pregnancy was complicated by gestational diabetes in the mother who was treated. She also had elevated liver function tests (LFTs) during pregnancy; otherwise, no additional problems were noted. He was 7 pounds 14 ounces. The patient was diagnosed with neonatal jaundice, treated with phototherapy and discharged three days after birth.

This baby boy with postnatal onset microcephaly had speech impairment and global developmental delay that were noted at 12 months of age. He also had feeding problems which included gagging, choking and frequent drooling. The mother also noted that the child has been sleeping more in recent weeks. According to the mother, the infrequent episodes are typified by the boy stopping suddenly, staring and becoming unresponsive. The child's history is negative for convulsions, meningitis, encephalitis or severe head trauma associated with loss of consciousness. There is no family history of developmental delay or neurological problems. The boy is characterized by frequent smiling and laughter, hyperactivity. He has a strikingly pale hair and unusually pale blue eyes. Involuntary hand movements, wide-based gait, and dystonically upgoing toes are noticed. The patient's physical examination is positive. An EEG was performed and showed a normal awake-and-asleep pattern; however, a subtle slow background frequency for age was noted. An MRI was positive. A blood sample from the patient was sent for DNA molecular testing.

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CLINICAL HISTORY 8	\|	CASE OF AKDIVAR AND OTHERS v. TURKEY

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