<s>[INST] My husband is totally blind from lebers optic neurothpathy and recently has had symtoms of constant lip licking espceially when he is tired which he isn t aware he is doing . He also has essential familinal tremors which is increased as he has got older He sometimes has some mild difficulty swallowing, Are these symptoms related to his Lebers neuropathy. [/INST] Hi, yes these other symptoms may be present in LION Vision loss is typically the only symptom of LION; however, some families with additional signs and symptoms have been reported. In these individuals, the condition is described as "LION plus." In addition to vision loss, the features of LION plus can include movement disorders, tremors, and abnormalities of the electrical signals that control the heartbeat (cardiac conduction defects). Some affected individuals develop features similar to multiple sclerosis, which is a chronic disorder characterized by muscle weakness, poor coordination, numbness, and a variety of other health problems. Thanks </s>