MND

Question 1

What is MND (Also: ALS)?

Answer 1

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder, characterised by progressive muscle weakness that can start in limb, axial, bulbar, or respiratory muscles and then generalises relentlessly, causing progressive disability and ultimately death, usually from respiratory failure.

Question 2

What are the risk factors of MND?

Answer 2

> Genetic predisposition

> Age >40 yrs

Question 3

What are the signs and symptoms of MND?

Answer 3

> upper extremity weakness
stiffness, with poor co-ordination and balance
spastic, unsteady gait
painful muscle spasms
difficulties in arising from chairs and climbing stairs
foot drop
stiffness and decreased balance with impact on gait
head drop
progressive difficulties in maintaining erect posture, with stooping
muscle atrophy
increased lumbar lordosis and tendency for abdominal protuberance
hyper-reflexia
dyspnoea
coughing and choking on liquids (including secretions) and eventually on food
strained, slow speech
slurred, nasal, and, at times, dysphonic speech

Question 4

What is the epidemiology of MND?

Answer 4

The incidence of ALS in Europe and the US is about 1.5 to 2.5 per 100,000 per year, with a prevalence of 2.7 to 7.4 per 100,000. The mean age of onset is about 57 years.

Question 5

What investigations would you do for MND?

Answer 5

> Clinical diagnosis
EMG
MRI brain and spine