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A 5-month-old boy is brought to his pediatrician by his mother with a 3-day history of abnormal movements. His mother first noticed a weird spasm when they returned from a camping trip with the family. Since then, several times per day, he experiences paroxysmal episodes of crying, bending at the waist, and jerking of the arms and legs. These episodes last 1-2 seconds, but occur in clusters every 20-30 seconds for several minutes. His mother's pregnancy was uncomplicated and he was born at term through spontaneous vaginal delivery. He is rolling over less frequently than before, has worse head control, and no longer smiles socially. His temperature is 98.6°F (37°C), blood pressure is 92/46 mmHg, pulse is 115/min, and respirations are 34/min. On examination, no dysmorphic features are noted. A 24-hour electroencephalography (EEG) is performed, during which the patient has one of these spells. During that spell, the findings shown in Figure A are seen. Which of the following is the pathophysiology of this patient's condition?
1. Abnormalities in T-type calcium channels
2. Anti-N-methyl-D-aspartate (NMDA) receptor antibodies
3. Decreased gamma aminobutyric acid (GABA) levels
4. Excess of corticotropin releasing hormone
5. Vitamin B6 deficiency
QID: 221322
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