Pathogenic DNM1l variants that disrupt mitochondrial dynamics are associated with multisystem involvement, including developmental delay, dystonia, epilepsy (most commonly refractory seizures and status epilepticus consistent with epileptic encephalopathy), ataxia, optic atrophy, microcephaly, peripheral neuropathy, respiratory distress, and childhood mortality (4). This evidence concerns the gene DNM1L and Global developmental delay.