“…Generally, TK2 mutations may manifest not only in the muscle but also in the brain as encephalopathy, epilepsy, or white or gray matter lesions, 2,3 in the peripheral nerves as axonal neuropathy, 3 in the liver as reduced mtDNA copy number, 4 in the ears as hearing loss, 5 or in the extraocular muscles as ptosis or chronic progressive external ophthalmoplegia. 5,6 Did the patient undergo neuropsychological testing to see if there were any cognitive deficits?…”