MND is a group of neurological disorders affecting neurones in motor cortex, CN nuclei and anterior horn cells.
MND affects UMN and LMN but there is no sensory involvement.
As a quick recap, UMN signs include:
- brisk reflexes
- upgoing plantars
LMN signs include:
- depressed reflexes
There are several patterns of MND, including:
- Amyotrophic lateral sclerosis
- presents as UMN signs in legs and LMN signs in arms
- may be familial - in which case often associated with Ch 21
- accounts for 50% of cases of MND
- has an 'intermediate' prognosis
- accounts for around 25% of cases of MND
- has the worst prognosis of the presentations
- more details in the next battle
- only LMN affected
- begins distally
- has a (relatively) good prognosis
- affects UMN only
Diagnosis of MND is primarily clinical.
EMG will show preserved motor conduction velocities
CSF analysis may show raised protein.
Treatment is with riluzole, which prolongs life by around 3 months and requires monitoring of LFTs. There is no cure.
As the first paragraph stated, the prognosis is very poor and most patients are dead within 5 years.
So on to battle 10.3, to learn more about bulbar palsy.