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For a recent review on TMAO and its links to diet and the microbiome see this review

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Some of the first symptoms of a metabolic crisis are: extreme sleepiness behavior changes irritable mood poor appetite Other symptoms then follow: fever nausea diarrhea vomiting hypoglycemia If a metabolic crisis is not treated, a child with CTD can develop: breathing problems swelling of the brain seizuresThese are also called "convulsions" or "fits." During a seizure, a person loses consciousness and control of his or her muscles

Carbamoyl phosphate synthetase is a key enzyme in the urea cycle, so impairment leads to urea cycle dysfunction with ammonia accumulation