Two infants with the neonatal type of nonketotic hyperglycinemia that had m
anifested as early neonatal consciousness disturbance are presented. Transi
ent hyperammonemia had been detected in both initially. High levels of glyc
ine in plasma and cerebrospinal fluid disturb the nervous system, causing v
ariable manifestations of this disease. Both cases were complicated by intr
acranial hemorrhage, which has never before been reported. After treatment
with sodium benzoate and dextromethorphan, some neurologic improvement was
observed, although the glycine levels did not lower. Recent clinical trials
are reviewed, and because of the unfavorable outcomes, the special need fo
r prenatal diagnosis is highlighted. (C) 1999 by Elsevier Science Inc. All
rights reserved.