Overall, inheritance of the homozygous ELOVL4 mutations, c.78C > G; p.Tyr26∗, and c.646C > T, p.Arg216X (41) in exon 5, and c.690del p.Ile230Metfs∗22 in exon 6 of ELOVL4 (40), causes dry, scaly, and thickened skin disorders (ichthyosis), intellectual disability, seizures, hypertonia, and premature death (40, 41). This evidence concerns the gene ELOVL4 and Hypertonia.