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Despite the name KCTD (potassium channel tetramerization domain), KCTD protein family members lack predicted channel domains. We sought to translate insight gained from yeast studies to uncover disease mechanisms associated with deficiencies in KCTD7 of unknown function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Novel <jats:italic>KCTD7<\/jats:italic> variants in new and published patients were assessed for disease causality using genetic analyses, cell\u2010based functional assays of patient fibroblasts and knockout yeast, and electron microscopy of patient samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with <jats:italic>KCTD7<\/jats:italic> mutations can exhibit movement disorders or developmental regression before seizure onset, and are distinguished from similar disorders by an earlier age of onset. Although most published <jats:italic>KCTD7<\/jats:italic> patient variants were excluded from a genome sequence database of normal human variations, most newly identified patient variants are present in this database, potentially challenging disease causality. However, genetic analysis and impaired biochemical interactions with cullin 3 support a causal role for patient <jats:italic>KCTD7<\/jats:italic> variants, suggesting deleterious alleles of <jats:italic>KCTD7<\/jats:italic> and other rare disease variants may be underestimated. Both patient\u2010derived fibroblasts and yeast lacking Whi2 with sequence similarity to KCTD7 have impaired autophagy consistent with brain pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Biallelic <jats:italic>KCTD7<\/jats:italic> mutations define a neurodegenerative disorder with lipofuscin and lipid droplet accumulation but without defining features of neuronal ceroid lipofuscinosis or lysosomal storage disorders. <jats:italic>KCTD7<\/jats:italic> deficiency appears to cause an underlying autophagy\u2010lysosome defect conserved in yeast, thereby assigning a biological role for KCTD7. 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