Motor Neuron Disease (MND) Flashcards
What is MND
Progressive, degenerative disorder of the cortical, brainstem and spinal motor neurones.
What does MND cause?
Causes denervation and atrophy of corresponding mm fibres
What is mean survival rates of MND
4 years
If you get limb symptoms, what does that mean is getting affected more in MND
Corticospinal tracts
If you get lower face symptoms , what does that mean is getting affected more in MND
Corticobulba.
What other symptoms come from corticobulbar affected
Bulbar signs include dysarhria, disphasia, emotional liblity. 9-10-12 CNN
Clinical presentation of MND- What are they?
- Insidious onset
- Up to 50% of motor neurones can be lost before weakness becomes apparent
- Typically wasting and weakness of limbs
- Cramps & fasciculations
- Combination of UMN and LMN signs: 10% of patients only ever develop LMN signs
Give examples of clinical presentation for both LMN and UMN degeneration of MND
LMN- Profound mm loss in specific locations
- hyporeflexia
- fasciculation
- reduced or normal tone
UMN- Widespread mm wasting
- hyperreflexia
hypertonia
primitive reflexes
What are four main types of MND
- Amyotrphic lateral scleoris (ALS)
- Progressive Bulbar Palsy (PBP)
- Progressive Muscular Atrophy (PMA
- Primary Lateral Scleorsis (PLS)
Phases and stages of disease, what are they for MND
3 phases.
Phase 1 has 3 stages- independent
- stage 1- mild weakness
- stage 2- moderate weakness- difficulty with stairs
- stage 3- severe selective weakness, decreased ADL’s
Phase 2 has 2 stages- partial dependence
- stage 4- shoulder pain, oedema in hands, severe lower limb weakness
- stage 5- severe ll weakness and some ul weakness
Phase 3 has 1 stage. total dependence.
What does a physio do with MND?
Stage 1- Flexibility and strengthening program
Stage 2- Continue stretching and strengthening to avoid contractures.
Stage 3- Deep breathing and postural drainage
Stage 4- Activated assisted ROM, heat and massage
Stage 6- Clear airways, postural drainage, positioning
