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This phenomenon, known as the threshold effect, explains why MELAS can present with a wide range of symptoms across different patients, depending on the mutation load and the tissues affected [11]
(13) Most patients with severe motor and intellectual disabilities have epilepsy and are prescribed anti-epileptic drugs such as valproate sodium, which promotes the excretion of carnitine
doi: 10.1038/s41380-022-01806-1
