TUBB4Aencompasses a broad spectrum, ranging from DYT4 to hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC) leukoencephalopathy, characterized by symptoms including dystonia, psychomotor delay, spasticity, ataxia, dysarthria, short stature, and microcephaly. DYT4 should not be categorized as an isolated dystonia. Here, TUBB4A is linked to cerebellar ataxia.