These findings are similar to the results of studies by Wolf and Grunewald et al. that reported biotin therapy in biotinidase deficient infants with seizures (untreatable form of seizures with antiepileptic drugs), cutaneous manifestation, visual and auditory abnormalities, neuroradiological findings such as encephalopathy, and lab data such as elevated blood lactate and pyruvate concentrations is important to reduce these manifestations (1,10). Here, BTD is linked to Encephalopathy.