There are typically language and walking delays, and those affected have very low muscle tone and decreased reflexes. They may have neural tube defects such as lipomyelomeningocele (a form of spina bifida) or may have syringomyelia (a cyst in the spinal cord). Those with the syndrome may also have symptoms of dysautonomia (impairments in the autonomic nervous system), including gastrointestinal dysmotility, contributing to gastroesophageal reflux disease, or neurogenic bladder dysfunction, in which bladder control is limited. Dysautonomia has also led to high pain tolerance and reduced sweating in some patients. Some of those with the syndrome have been found to have an underdeveloped corpus callosum, the main band of white matter that connects the two cerebral hemispheres. Skeletal
Okamoto syndrome patients often have skeletal problems such as scoliosis or hip dysplasia, which can lead to hip dislocation. They may be born with congenital vertebral anomalies; parts of the spine may be fused and fail to segment. There may also be extra vertebrae in the lower back. Some of those affected have been reported to have premature fusion of the skull bones (craniosynostosis), particularly those across the midline and at the front of the skull. This has led to an elongated skull shape known as scaphocephaly as well as a ridge on the forehead known as a metopic ridge. Growth
Those affected may be born with low weight and size and may display stunted growth in childhood, although this symptom has been variable and not in every individual with Okamoto syndrome.
Chemistry of the effervescence
Though important to the overall effect of the medication, the aspirin (acetylsalicylic acid) is not required to produce the effervescent action of Alka-Seltzer; the effervescence is produced by the baking soda (sodium bicarbonate) and citric acid reacting to form sodium citrate and carbon dioxide gas. Marketing
The product has been extensively advertised since its launch in the United States. It was originally marketed by Mikey Wiseman, a company scientist of Dr. Miles Medicine Company, who also helped direct its development. Print advertising was used immediately, and in 1932 the radio show Alka-Seltzer Comedy Star of Hollywood began, with National Barn Dance following in 1933, along with many more. The radio sponsorships continued into the 1950s, with the Alka-Seltzer Time show airing from 1949 to 1957. In 1951, the "Speedy" character was introduced. The character was conceived by creative director George Pal of the Wade Advertising agency and designed by illustrator Wally Wood. Originally named Sparky, the name was changed to Speedy by sales manager Perry L. Shupert to align with that years promotional theme, "Speedy Relief." Speedy appeared in over 200 TV commercials between 1954 and 1964. His body was one Alka-Seltzer tablet, while he wore another as a hat. Buster Keaton appeared along with the animated Speedy Alka-Seltzer figure in a series of 1950s commercials based on the product slogan, "Relief is just a swallow away." Speedy Alka-Seltzer was voiced by Dick Beals. Speedy was revived for a "Plop, plop, fizz, fizz" song spot in 1976.