TPP1 and cerebellar ataxia: According to a case series with 14 patients with atypical CLN2, ataxia, language regression, seizures, and vision disturbance are the most common clinical manifestation with the progression of the disease.20However, only 3% of the South America cohort presented visual impairment in the first year; the mean age for the appearance of this symptom was 11.47 ± 5.04 years old.13Cognitive decline was present in 93% of the population of the present study, 7% had it as first symptom and 67% occurred within the 1styear after the appearance of seizures.13