Though some don't match the defined protocols, the majority of individuals with MSUD fall into four subtypes. Classic MSUD is apparent within the first few days of birth. The baby does not feed well from the breast or the bottle. Without these nutrients, the child becomes irritable and lethargic. As she disengages, neurological signs such as athetosis, slow and convoluted writhing movements of the digits, limbs, neck and tongue, may develop. This progresses to hypertonia, where muscles become rigid even when at rest. Spasms, convulsions, and coma may also occur, and at a certain point, neurological and respiratory failure are inevitable.
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