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Three exclusively breastfed male infants (Case 1, 3 months; Case 2, 7 months; and Case 3, 6 months of age) presented to our emergency department with vomiting, bilateral non-fatiguable ptosis and altered sensorium in form of lethargy, excessive crying and moaning (figures 1 and 2). Ophthalmic examination in addition revealed abduction deficits. There was no nystagmus. The rest of CNS examination was unremarkable. Maternal dietary history was notable for a diet consisting of polished rice as a …
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