MND

Question 1

what is MND?

Answer 1

rare and progressive disease that damages part of the nervous system leading to weakness and visible muscle wasting. motor neurones are targeted in the brain, SC and CN so muscles stop getting instructions from the brain as well as they did before.

Question 2

what causes it?

Answer 2

cause currently unknown although it seems to be linked to some genes. increased if FHX of MND or front-temporal dementia.

Question 3

is it genetic?

Answer 3

cause unknown.

Question 4

what symtpoms?

Answer 4

trouble with gripping, walking, speaking, swallowing and breathing. sx come on over a few weeks usually on one side of the body and then spread and get worse.
early sx: foot drop (weak ankle muscles); weakened grip, unable to lift arm, dragging leg, slurred speech

never effects eyes, sphincters or sensation

Question 5

treatment?

Answer 5

no cure. aim to make them comfortable and keep QoL
riluzole- antiglutamatergic: prolongs life for 3 months.
sx control:
- drooling: amitryptilline
- feeding tube: dysphagia
- breathing mask
- spasticity: baclofen

Question 6

prognosis?

so what might the family want to organise now?

Answer 6

2-4 yrs from diagnosis. ADL’s will become more difficult so will need a lot more help around the house
- will, advance directive, lasting power of attorney

Question 7

support?

Answer 7

social services: care package (carers, finances)
- MDT: palliative nurses, neurologist, dietician

motor neurone disease association have info on living wth MND and the emotional impact. also run specialist hospital clinics where a MND neurologist can give you more info and advice

Question 8

types?

Answer 8

Amyotrophic lateral sclerosis, progressive bulbar palsy, progressive muscular atrophy, primary lateral sclerosis

Question 9

which is most common?

Answer 9

ALS

Question 10

how is it diagnosed?

Answer 10

usually clinical by a neurologist- el escorial diagnostic criteria
nerve conduction study