Neurological Manifestations:

Neurological difficulties are often present such as hypertonic and hypotonic
muscles; musculoskeletal asymmetry and dysfunction involving muscles, ligaments and joints;
atypical patterns of numbness and tingling;
abnormal muscle twitch response, muscle cramps, muscle weakness and fasciculations;
TMJ disorder;
Generalized weakness, perceptual disturbances, spatial instability, and
sensory overload phenomena often occur.

Neurocognitive Manifestations:

neurocognitive difficulties usually are present. These include impaired
concentration and short-term memory consolidation;
impaired speed of performance;
inability to multi-task,
and/or cognitive overload.

Other Manifestations:

Fatigue: There is persistent and reactive fatigue accompanied by reduced physical and mental stamina which often interferes with the patient's ability to exercise.;
Sleep Dysfunction: The patient experiences unrefreshing sleep. This is usually accompanied by sleep disturbances including insomnia, frequent nocturnal
awakening, nocturnal myoclonus, and/or restless leg syndrome.

Autonomic and/or Neuroendocrine Manifestations:

cardiac arrhythmias,
neurally mediated hypotension;
vasomotor instability;
sicca syndrom;
temperature instability;
heat/cold intolerance;
respiratory disturbances;
intestinal and bladder motility disturbances with or without irritable
bowel or bladder dysfunction;
loss of adaptability and tolerance for stress, emotional flattening,
lability, and/or reactive depression.
Stiffness: It is common for generalized or regional
stiffness that is most severe upon awakening and typically
lasts for hours, to occur. Stiffness can return during
periods of inactivity during the day

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