Borlot et al recently investigated the diagnostic yield of a commercially available epilepsy gene panel in an adult population with epilepsy and intellectual disabilities. The cohort was enriched with patients more likely to harbor a genetic etiology, excluding those with phenotypes consistent with classic chromosomal disorders and those with imaging findings that explained their condition. Of 64 eligible patients, 14 (21.8%) had pathogenic or likely pathogenic mutations and 8 (57%) patients had a diagnostic change from their working clinical diagnosis prior to testing. This finding is encouraging, as it demonstrates yield in adults is similar to that in pediatric populations. For some, the molecular diagnosis altered the course of therapy, though the impact on outcome was beyond the scope of this study. Four patients were identified with conditions where treatment might change, 3 with Dravet syndrome (one was noted to improve when sodium channel blocking antiseizure medications were stopped) and 1 with GLUT-1. Another was found to have Koolen-de Vries syndrome and now has the opportunity to connect with the small community of others with the same condition, the benefits of which are difficult to measure. However, for patients whose treatment was not changed based on diagnosis, learning the condition they have lived with for years was incorrect may have adverse consequences. One such case with a presumptive diagnosis of Angelman’s was found to have ID31 (OMIM #616158). In the day of social media, many patients and families become strongly connected to a network of advocates for their condition and a loss of that identity is potentially harmful, but again difficult to measure. While it is worth recognizing the potential pitfalls of establishing a genetic diagnosis late in life, the potential value to patients in the end cannot be discounted.