The following description of the broad clinical spectrum is based on 20 individuals (Chen et al., 2016).
Growth parameters
Usually normal.
Neurological features
Individuals with BBSOAS have developmental delay and intellectual disability. However, low normal IQ has been described. Neonatal hypotonia is common and oral motor dysfunction is present in about half of the cases. Seizures are variable present, ranging from no epilepsy to infantile spasm to onset of seizures at the age of 18 years. Thinning of the corpus callosum can be present and delayed myelination was reported. One individual with spasticity was described.
Neuropsychological disorders
Behavioral problems are present in about half of the individuals with BBSOAS, including autism spectrum disorder and/or ADHD. Repetitive behavior is also observed.
Facial dysmorphism
No specific facial dysmorphisms are observed.
Visual and hearing impairments
Many individuals have vision impairment, due to optic nerve atrophy, optic nerve hypoplasia and/or cerebral visual impairment.
Hearing impairment can also be present in persons with BSSOAS.
Congenital abnormalities
Based on the current knowledge there is no increased risk for congenital abnormalities, such as cardiovascular defects, renal or urogenital anomalies, or gastro-intestinal anomalies.