A 6 years old girl who was born via NSVD to a healthy 20 years old primigravida following a pregnancy that was complicated by threatened abortion. The antenatal and perinatal histories were unremarkable, and she was discharged on the second day. The first abnormality was noted at 14 months of age when she had tip-toeing and extensive investigations at that time were normal. She had two seizures at 26 and 28 months of age, and she has been seizure-free since then. She is now off medications. However, the primary concern was noted at the age of three years when she had an expressive language delay. Her cognitive abilities, in general, were reduced. She was evaluated by a psychiatrist and was diagnosed with ADHD and was started on medications. She also had an estimated IQ of 76. Her mother also noticed that she has frequent sleep panic attacks. Her parents are nonconsanguineous with another mildly affected daughter. Her father also has mild cognitive impairment, and there are multiple family members affected on the paternal side. Physical examination revealed mild hypertelorism and hypopigmentation on the back, and other examinations were within normal limits. Her growth parameters at 9 years of age were weight 44.2 kg ( >97th percentile), height 150 cm (>97th percentile, +2.64 SD) and head circumference 55.5 cm (>99th percentile, + 2.68 SD). EEG, brain MRI, CBC, tandem mass spectrometry and CGH microarray were within normal limits.