Motor neurone disease


Disease modifying treatment available:
Time critical diagnosis and management:
Lateralising:


Synonyms

  • Motor neuron disease


Definition

There are unfortunate inconsistences between the use of the terms 'motor neurone disease' and 'amyotrophic lateral sclerosis'.

In the UK, motor neurone disease is just one of many motor neurone diseases. Motor neurone diseases is used to define a group of disorders in which there is preferential degeneration of motor neurones. This group of disorders includes motor neurone disease, polio, multifocal motor neuropathy with conduction block and others. Motor neuron disease is the most common of the motor neurone diseases. Motor neurone disease is distinguished from these other motor neurone disorders of the basis of aetiology (including genetics), clinical features, histopathology and electrophysiology. Motor neurone disease is then further categorised depending on the regions of the body involved and the distribution of upper and lower motor neurone diseases. The most common variant of motor neurone disease is amyotrophic lateral sclerosis which refers to motor neurone disease affecting the spinal and bulbar motor neurones with mixed upper and lower motor neurone features.

In the USA, the terms motor neuron disease and amyotrophic lateral sclerosis are truely interchangable.

In American English 'neurone' is spelt 'neuron'. While this is trivial in clinical practice it is of relevance when searching the literature.




Taxotomy

Subclassifications Epidemiology Clinical features
Amyotrophic lateral sclerosis None Weakness
Fasciculations
Tongue fasciculations
Progressive muscular atrophy None
Primary lateral sclerosis None
Progressive bulbar palsy None



Aetiology

Associated genes

Gene
C9orf72 Search ClinVar Search ClinGen
TARDBP Search ClinVar Search ClinGen
FUS Search ClinVar Search ClinGen
SOD1 Search ClinVar Search ClinGen



Clinical features



Motor neurone disease may cause the following:





Treatment


Management is primarily supportive. Riluzole is thought to improve survival by a number of months.

As the disease progresses, complications associated with neuromuscular ventilatory failure, dysphagia or prolonged immobility generally lead to death.


Pharmacological treatments