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Energy metabolism and feeling tired Under normal conditions, L-carnitine acts as a shuttle so that fatty acids enter the mitochondrion and are used as fuel, especially during periods of fasting or exercise

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This condition was first described in 1966 (76) and may present as a subacute or acute encephalopathy with seizures and stroke-like episodes, often in association with myoclonus and tremor (77)

Thus, other hypotheses explaining the relationship between glucose/glycogen metabolism and neurotransmission have been proposed, including the glucose sparing by glycogenolysis (GSG) hypothesis (Figure 4e