 Neem and Pixie disease, NPC, is a rare neurobiceral lysosomal lipid storage disorder with an estimated incidence of 1-1-20-0-0-0 live births. The clinical spectrum ranges from neonatal to adult forms, characterized by neurological involvement and systemic signs such as cholestatic jaundice or isolated spleenomegaly. The most common neurological symptoms include ataxia, dysarthria, dysphagia, and progressive dementia with cataplexy, seizures, and dystonia also present in some cases. NPC is caused by mutations of the NPC1 or NPC2 genes which are involved in cellular cholesterol trafficking. The primary laboratory diagnosis involves staining of living skin fibroblasts for unsterified cholesterol accumulation in perineuclear vesicles, lysosomes. Genotyping is useful for confirming the diagnosis and future prenatal diagnosis. Treatment options include symptomatic management with midlaster being granted marketing authorization for specific treatment of neurological manifestations. The prognosis largely correlates with the agent onset of neurological symptoms. This article was authored by Vonia Muriti. We are article.tv, links in the description below.