Inheritance of the homozygous ELOVL4 variant, c.78C > G; p. Tyr26 ∗ and c.646C > T, p. Arg216X (41) located in exon 5, and c.690del p. Ile230Metfs ∗ 22 in exon 6, causes intellectual disability, seizures, hypertonia, and premature death [15, 16], which underscores the critical role of functional ELOVL4 for normal growth and survival. This evidence concerns the gene ELOVL4 and Intellectual disability.