Seizure management is often difficult, requiring subspecialized neurologic care and multiple anti-epileptics. Cataracts may present at birth or during childhood and may require surgical intervention. Feeding difficulties or intolerance may require gastrostomy or other feeding assistance.  Neurodevelopmental assessment may identify areas where additional support or intervention is needed. There is no single intervention recommended for the bouts of extreme and disabling irritability, but some have responded favourably to sedatives and parents anecdotally report that they begin to improve in severity and frequency around 5 years of age.