{"0": "Mental deterioration", "1": "Muscle abnormality related to mitochondrial dysfunction", "2": "Optic neuropathy", "3": "Abnormal brainstem mri signal intensity", "4": "Increased csf lactate", "5": "Dementia", "6": "Abnormality of the mitochondrion", "7": "Cognitive impairment", "8": "Mitochondrial myopathy", "9": "Abnormality of hepatobiliary system physiology", "10": "Abnormal activity of mitochondrial respiratory chain", "11": "Ragged red muscle fibers", "12": "Decreased activity of mitochondrial complex i", "13": "Hepatic failure", "14": "Abnormal mitochondria in muscle tissue", "15": "Abnormality of the cerebrospinal fluid", "16": "Horizontal nystagmus", "17": "Abnormal csf metabolite level", "18": "Abnormal circulating lipid concentration", "19": "Myoclonus", "20": "Abnormal retinal artery morphology", "21": "Focal t2 hyperintense brainstem lesion", "22": "Sensorimotor neuropathy", "23": "Optic disc pallor", "24": "Proximal tubulopathy", "25": "Hypertrophic cardiomyopathy", "26": "Abnormality of head blood vessel", "27": "Increased serum lactate", "28": "Myoclonic seizure", "29": "Phenotypic variability", "30": "Bulbar signs", "31": "Toe walking", "32": "Episodic vomiting", "33": "Abnormal circulating cholesterol concentration", "34": "Poor head control", "35": "Generalized myoclonic seizure", "36": "Paroxysmal involuntary eye movements", "37": "Left ventricular hypertrophy", "38": "Delusions", "39": "Impaired proprioception", "40": "Splenomegaly", "41": "Abnormal muscle fiber morphology", "42": "Cherry red spot of the macula", "43": "Morphological abnormality of the pyramidal tract", "44": "Elevated hepatic transaminase", "45": "Ventricular hypertrophy", "46": "Abnormal cardiac ventricular function", "47": "Increased serum pyruvate", "48": "Schizophrenia", "49": "Abnormality of corneal stroma"}