Even though one BPAN case with a demonstrable mutation in WDR45 and no iron accumulation (Hoffjan et al. 2016) and another case with the appearance of iron only later in the course of the disease (Okamoto et al. 2014) have been reported, iron accumulation is usually detected as a radiological sign at the same time or soon after the clinical symptoms of progressive dystonia-parkinsonism appear. This evidence concerns the gene WDR45 and neurodegeneration with brain iron accumulation 5.