Sir.—The article by Aughton and Cassidy1 in the November 1990 issue of AJDC added useful information on the characteristics of neonates with Prader-Willi syndrome (PWS). Unlike Aughton and Cassidy, who did not examine the patients in the neonatal period (or so it appears from their article) and whose study was retrospectively derived from medical records, I have diagnosed a substantial number of newborns with PWS before and after my study in 1980.2 I conclude that if pediatricians, neonatologists, pediatric neurologists, or geneticists consistently notice an abnormal finding, this is evidence of its importance (for example, the consistently abnormal cry).1 How"String sign" of sticky saliva (arrow) in a 2-week-old girl with clinical Prader-Willi syndrome. ever, failure to observe what I regard as characteristic features may reflect inadequate examination technique, limited experience, or difficulty in recognizing novel or unexpected phenomena.
I have previously suggested2 that the typical
STEPHENSON JBP. Neonatal Presentation of Prader-Willi Syndrome. Am J Dis Child. 1992;146(2):151–152. doi:10.1001/archpedi.1992.02160140017010