The largest other single-center cohort so far reported is a Dutch cohort of 46 unrelated families.13 We propose that the phenotype of cerebellar ataxia (with marked dysarthria), mild lower limb spasticity, and waddling gait is clinically distinct and should alert clinicians to direct genetic testing for SPG7. Such an approach identified 64% of our cohort. Here, SPG7 is linked to aceruloplasminemia.