The patient is a female infant lying supine on the examination table with oxygen per nasal canula in no distress. She is afebrile with stable vital signs. Anterior fontanelle is soft. She has minimal facial movements, without dysmorphic features. Pupils appear dilated and are sluggish to react to light.
Bilateral ptosis is appreciated, however extraocular muscle movements appear to be intact.
There is a depressed gag reflex with weak cry. No spontaneous movement is observed in the upper limbs with the exception of trace finger movement bilaterally. No atrophy or fasciculations are noted. The infant demonstrates a weak cry in response to sensory testing. Muscle stretch reflexes are hypoactive throughout with plantar responses bilaterally.