4-Hydroxybutyric Aciduria as a Rare Presentation of Global Developmental Delay in Children: Case Report of Two Different Patients

Succinic semialdehyde dehydrogenase (ssadh) deficiency or 4-hydroxybutyric aciduria is an autosomal recessive inherited disorder of amma-aminobutyric acid (gaba) degradation. it is characterized by developmental delay, infantile-onset hypotonia, cognitive impairment language deficit, and ataxia. epilepsy, aggression, hyperkinetic behavior, hallucinations, and sleep disturbances have been described in about half of the patients, more frequently in older individuals. its management is largely symptomatic, conducted at the treatment of seizures and neurobehavioral disorder. we present two girls with chief complaint of hypotonia and developmental delay how referred to department of pediatrics (ghaem hospital), mashhad, iran.