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Muscle
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==In ME and CFS== Several of the key symptoms observed by [[Melvin Ramsay]] and a part of his [[Ramsay definition]] involved '''muscle''' including [[muscle fatigability]] along with muscle [[pain]] and clumsiness ([[ataxia]]). Patients also complain of [[muscle fasciculations]]. Numerous abnormalities have been found in the [[skeletal muscle]] of [[Myalgic Encephalomyelitis]] patients including: *[[Mitochondrion|mitochondria]]l abnormalities found via [[muscle biopsy]] including: mitochondrial degeneration<ref>{{Cite journal | last = Behan | first = W. M.H. | last2 = More | first2 = I.A.R. | last3 = Behan | first3 = P.O. | date = Dec 1991 | title = Mitochondrial abnormalities in the postviral fatigue syndrome|url=https://link.springer.com/article/10.1007/BF00294431|journal=Acta Neuropathologica|language=en|volume=83|issue=1 | pages = 61β65|doi=10.1007/bf00294431|issn=0001-6322|via= | authorlink3 = Peter Behan}}</ref>, deletions of mitochondrial DNA <ref name=":0">{{Cite journal | date = 1996-04-19 | title = Sensory characterization of somatic parietal tissues in humans with chronic fatigue syndrome|url=https://www.sciencedirect.com/science/article/abs/pii/0304394096125593|journal=Neuroscience Letters|language=en|volume=208|issue=2|pages=117β120|doi=10.1016/0304-3940(96)12559-3|issn=0304-3940}}</ref><ref name=":1">{{Cite journal | last = Zhang | first = C. | last2 = Baumer | first2 = A. | last3 = Mackay | first3 = I.R. | last4 = Linnane | first4 = A.W. | last5 = Nagley | first5 = P. | date = Apr 1995 | title = Unusual pattern of mitochondrial DNA deletions in skeletal muscle of an adult human with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/7633428|journal=Human Molecular Genetics|volume=4|issue=4 | pages = 751β754|issn=0964-6906|pmid=7633428}}</ref>, the reduction of mitochondrial activity<ref name=":0" /> *Increased urinary [[creatine]] excretion during relapses<ref>{{Cite journal | last = Albrecht | first = Robert | date = March 21, 1964 | title = Epidemic Neuromyasthenia Outbreak in a Convent in New York State|url=https://www.ncbi.nlm.nih.gov/pubmed/14100144|journal=Journal of the American Medical Association|volume=187 | pages = 904-907|via=}}</ref> *Increased [[creatine kinase]] ([[postviral fatigue syndrome]]) *Persistence of [[enterovirus]]es in muscle tissue<ref>{{Cite journal | last = Gow | first = J.W. | last2 = Behan | first2 = W. M.H. | last3 = Simpson | first3 = K. | last4 = McGarry | first4 = F. | last5 = Keir | first5 = S. | last6 = Behan | first6 = P.O. | date = 1994-01-01 | title = Studies on Enterovirus in Patients with Chronic Fatigue Syndrome|url=https://academic.oup.com/cid/article-abstract/18/Supplement_1/S126/316946|journal=Clinical Infectious Diseases|language=en|volume=18|issue=Supplement_1|pages=S126βS129|doi=10.1093/clinids/18.Supplement_1.S126|issn=1537-6591|via= | authorlink6 = Peter Behan}}</ref><ref>{{Cite journal | last = Cunningham | first = Louise | last2 = Bowles | first2 = N.E. | last3 = Lane | first3 = R. J.M. | last4 = Dubowitz | first4 = V. | last5 = Archard | first5 = L.C. | date = 1990 | title = Persistence of enteroviral RNA in chronic fatigue syndrome is associated with the abnormal production of equal amounts of positive and negative strands of enteroviral RNA|url=http://jgv.microbiologyresearch.org/content/journal/jgv/10.1099/0022-1317-71-6-1399|journal=Journal of General Virology|volume=71|issue=6|pages=1399β1402|doi=10.1099/0022-1317-71-6-1399}}</ref><ref>{{Cite journal | last = Archard | first = LC | last2 = Bowles | first2 = N E | last3 = Behan | first3 = P O | last4 = Bell | first4 = EJ | last5 = Doyle | first5 = D | date = 1988-06-01 | title = Postviral Fatigue Syndrome: Persistence of Enterovirus RNA in Muscle and Elevated Creatine Kinase, Postviral Fatigue Syndrome: Persistence of Enterovirus RNA in Muscle and Elevated Creatine Kinase|url=https://doi.org/10.1177/014107688808100608|journal=Journal of the Royal Society of Medicine|language=en|volume=81|issue=6|pages=326β329|doi=10.1177/014107688808100608|issn=0141-0768|pmc=|pmid=3404526|via= | authorlink3 = Peter Behan}}</ref><ref>{{Cite journal | last = Gow | first = J.W. | last2 = Behan | first2 = W.M. | last3 = Clements | first3 = G.B. | last4 = Woodall | first4 = C. | last5 = Riding | first5 = M. | last6 = Behan | first6 = P.O. | date = 1991-03-23 | title = Enteroviral RNA sequences detected by polymerase chain reaction in muscle of patients with postviral fatigue syndrome.|url=https://www.bmj.com/content/302/6778/692|journal=BMJ|language=en|volume=302|issue=6778 | pages = 692β696|doi=10.1136/bmj.302.6778.692|issn=0959-8138|pmid=1850635|via= | authorlink6 = Peter Behan}}</ref>
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