In Reply.—

We thank Drs Welch and Milligan for calling our attention to their interesting case. They describe a neonate who at four days of age had hyperbilirubinemia and neurologic dysfunction. At six days, cerebral edema was demonstrated by ultrasonographic examination. Galactosemia (transferance deficiency) was subsequently diagnosed. Neuroimaging procedures such as CT and ultrasound are invaluable diagnostic aids for the early identification of cerebral edema and may, as the authors suggest, provide evidence that cerebral edema occurs commonly in the acute phase of galactosemia.

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