Motor neurone disease (MND)

Motor neurone disease (MND) is a progressive neurological condition that attacks the motor neurones, or nerves, in the brain and spinal cord. MND affects around two in every 100,000 people in the UK and is most commonly diagnosed in people over the age of 40. However, it can affect younger people too. The symptoms of MND can include weakness and wasting in the muscles, problems with speech and swallowing, and eventually paralysis. There is no cure for MND and it is always fatal. However, there are treatments available to help manage the symptoms and slow down the progression of the disease.

What is Motor Neurone Disease?

Motor neurone disease (MND) is a rare and incurable neurological condition that affects the brain and spinal cord.

MND attacks the motor neurons – the cells that control the muscles – causing them to waste away. This leads to weakness and paralysis in the muscles, which get progressively worse over time.

There is no cure for MND, but there are treatments that can help slow down its progression and improve quality of life for people with the condition.

Around 70% of people with MND die within two to five years of diagnosis, so it is a very debilitating disease. However, some people with MND live for many years, often 10 years or more.

What are the symptoms of Motor Neurone Disease?

The symptoms of MND can differ from person to person, but the most common symptom is muscle weakness. This can start in any part of the body, but usually first affects the muscles in the face, hands, feet or legs.

Other symptoms can include:

• Muscle twitching or cramping
• Loss of feeling in parts of the body
• Difficulty speaking or swallowing
• Excessive tiredness
• Weight loss
• Breathing difficulties

What causes Motor Neurone Disease?

Motor neurone disease (MND) is a progressive neurological condition that attacks the motor neurones, or nerves, in the brain and spinal cord. This means messages from these nerves are progressively lost, leading to muscle weakness and wasting.

There are many different types of MND, but the most common is ALS (amyotrophic lateral sclerosis), which makes up around 50-60% of all cases. Other types include primary lateral sclerosis (PLS) and progressive bulbar palsy (PBP).

There is currently no known cure for MND, but there are treatments available to help manage symptoms and slow down the progression of the disease.

The exact cause of MND is still unknown, but it is thought to be caused by a combination of genetic and environmental factors.

When should I see a doctor?

If you have any of the symptoms of motor neurone disease, it's important to see a doctor as soon as possible. The earlier the disease is diagnosed, the more information and support you'll have available to you.

There's no single test for motor neurone disease, so your doctor will need to carry out a number of tests and investigations to rule out other conditions with similar symptoms. These may include blood tests, MRI scans and nerve conduction studies.

If your doctor suspects you have motor neurone disease, they will refer you to a specialist for further assessment.

How is Motor Neurone Disease diagnosed?

There is currently no single test that can diagnose MND. Instead, the diagnosis is made based on a combination of clinical features, family history, and diagnostic tests.

The first step in diagnosing MND is taking a thorough medical history and conducting a physical examination. Your doctor will ask about your symptoms and when they began. They will also ask about your family history, as MND can run in families.

Diagnostic tests that may be conducted to help confirm a diagnosis of MND include:

• Electromyography (EMG): This test measures the electrical activity of muscles at rest and during contraction. Abnormalities in the EMG may suggest damage to the motor neurons.

• Magnetic resonance imaging (MRI): This scan creates detailed images of the inside of the body and can often detect areas of abnormality in the brain or spinal cord.

• Spinal tap: Also called a lumbar puncture, this procedure involves removing a small amount of cerebrospinal fluid (the fluid that surrounds the brain and spinal cord) for analysis. Abnormalities in the fluid may suggest damage to the motor neurons.

Once all of the information has been gathered, your doctor will make a diagnosis based on clinical criteria set forth by international consensus guidelines.

How is Motor Neurone Disease treated?

There is no known cure for motor neurone disease (MND), however there are a range of treatments that may help to relieve symptoms and slow down the progression of the condition.

The main aim of treatment is to maximise quality of life and independence for as long as possible. Treatment will be tailored to each individual, taking into account their symptoms, general health and personal preferences.

There are a number of different medications that may be prescribed to help manage MND symptoms, such as muscle weakness, cramps and spasms. Antidepressants may also be recommended to help with any associated depression and anxiety.

In some cases, surgery may be required to help improve quality of life. For example, if someone is experiencing swallowing difficulties, a feeding tube may be inserted in order to ensure they receive adequate nutrition. If breathing problems become severe, ventilation via a tracheostomy (a hole in the neck through which a tube is inserted into the windpipe) may be required.

Occupational therapy, physiotherapy and speech and language therapy can all play an important role in helping people with MND to maintain their independence and quality of life for as long as possible. These therapies can help with things like fatigue management, pain relief, maintaining mobility and communication.

Can Motor Neurone Disease be prevented?

There is currently no known way to prevent motor neurone disease (MND). However, there are some things that may help reduce your risk of developing the condition. For example, if you smoke, quitting smoking may help lower your risk. Additionally, eat healthy diet and exercising regularly may also help reduce your risk of developing MND.

What are the complications of Motor Neurone Disease?

There are a number of potential complications associated with Motor Neurone Disease, including:

Respiratory failure: As the muscles responsible for breathing weaken, patients may require mechanical ventilation to assist with their breathing.

Swallowing difficulties: The weakening of the muscles used for swallowing can lead to aspiration and choking. Patients may need to be fed through a tube inserted into the stomach.

Urinary incontinence: The weakening of the muscles used for urination can lead to incontinence. Patients may need to use catheters or wear absorbent pads.

Pressure sores: The weakened state of the muscles can make it difficult for patients to move, increasing the risk of developing pressure sores.

Depression: The degenerative nature of MND can lead to feelings of hopelessness and despair. It is important for patients and caregivers to be aware of this possibility and seek counseling if necessary.

Resources and support

When you are diagnosed with MND, it can be a very overwhelming and scary time. There are many resources and support available to help you and your family through this difficult time.

The Motor Neurone Disease Association (MNDA) is a great resource for information and support. They have a helpline that you can call for advice, or you can search their website for information on all aspects of MND.

Your local community may also have resources and support groups available. Your health care team will be able to point you in the right direction.

There are also many online support groups available, which can be a great way to connect with others who are going through similar experiences.