An MSL-like phenotype has also been observed in a subset of patients with highly active antiretroviral therapy–associated lipodystrophy syndrome (71, 72), in individuals with myoclonic epilepsy with ragged-red fibers (73, 74), and patients with biallelic variants in mitofusin-2, typically including a p.Arg707Trp allele (MFN2) (75, 76). Here, MFN2 is linked to myoclonic epilepsy.