We identified monozygotic triplets with epilepsy and autism who inherited two homozygous recessive genetic variants of interest from their consanguineous parents who were heterozygous for both genes: a missense coding variant in VPS13B and a splice site loss variant in NAPB. It is predicted that the NAPB variant is a splice site loss that would result in skipping of the 47 bp exon 4, thereby creating a frame shift that produces a truncated or completely untranslated NAPB protein. The gene discussed is VPS13B; the disease is epilepsy.