MND Flashcards
What is motor neurone disease?
Degeneration of the neurones in the motor cortex, cranial nerve nuclei and anterior horn cells.
Are there any known causes of MND?
Viruses have been implicated
What neurones (UMN/LMN) are affected?
BOTH
What is odd about the fact that LMN are affected and the symptoms of MND?
NO SENSORY LOSS
NO SPHINCTER DISTURBANCE
What are the three diagnostic criteria in MND?
- Bulbar palsy
- Amyotrophic lateral sclerosis
- Progressive muscular atrophy
What LMN signs are present in MND?
Muscle fasciculations
Wasting
Weakness
What UMN signs are present in MND?
Hyperreflexia
Hypertonia
Spastic gait while still mobile
DDx?
MS
Myasthenia
How are MS and myasthenia ruled out?
MS = there is sensory involvement
Myasthenia = MND has no effect on external eye movements
Tests for MND?
Clinical based diagnosis
CT/MRI to rule out structural abnormality
If CT okay do an LP to rule out inflammation
Neurophysiology to investigate extent of muscle denervation
Pharmacological treatment of MND?
Antiglutamate drugs
Pain - use analgesia ladder
- Muscle relaxants
- Antispasmodics
What antiglutamate drugs can be given and how long do they increase survival?
Riluzole
- Only increases survival by 3 or so months
- Discuss this with patient
Other treatment?
Supportive
Palliative
PEG tube
Physio (though movement becomes painful)
Soft diet for bulbar palsy
