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Motor neurone diseases (MND) are a group of uncommon neurodegenerative conditions that can cause muscle weakness and paralysis. Based on the 2019 Global Burden of Disease Study, about 3.37 people per 100,000 globally had MNDs, and about 0.79 new cases per 100,000 people were diagnosed1. India has a lower prevalence and incidence of MNDs compared to regions like North America, Western Europe, and Australasia. However, conditions like amyotrophic lateral sclerosis (ALS) are still diagnosed in the country, affecting around 4 out of every 100,000 people2. The onset of MNDs can happen at any age, but symptoms typically occur after age 503. In India, nevertheless, signs often appear a decade earlier, specifically for ALS4. This blog explores the causes, types, symptoms, and treatments of MNDs to raise awareness and improve patient outcomes.
Synopsis
Understanding MNDs
Motor neurones are crucial in sending, transmitting, and receiving signals between the brain, spinal cord, and muscle. They are of two types: upper motor neurones in the brain and lower motor neurones in the spinal cord. They form a two-neurone pathway, controlling movement and other basic functions. In individuals with MND, this pathway is disrupted, leading to loss of motor functions. MNDs can damage either or both types of motor neurones, resulting in varying complications.
Causes of MNDs
The motor neurone disease causes are not fully understood. Most cases occur sporadically, i.e., they develop without any family history or known genetic cause. Only five to 10 percent of cases are hereditary, mainly due to genetic mutations, for example, spinal muscular atrophy (SMA). Several mutations have been identified that link to MNDs. Toxic, viral, and other environmental factors may also trigger the onset of disease.
Types of MNDs
MNDs are typically categorised based on the type of motor neurones affected.
|
Types |
Description |
Diseases |
|
Upper Motor Neurone Dysfunction |
Identified by the disruption of communication between the brain and lower motor neurones of the spinal cord |
Primary lateral sclerosis (PLS) |
| Lower Motor Neurone Dysfunction |
Characterised by the inability to send messages from the spinal cord to the muscles or glands of the body |
Kennedy’s disease |
|
Both Dysfunction in Upper Motor and Lower Motor Neurones |
Marked by interruption or problems in communication between the upper and lower motor neurones, as well as between the lower motor neurones and muscles |
Progressive bulbar palsy |
Symptoms of MNDs
MND symptoms can vary based on the stage, i.e., early, middle, and advanced, and the type of disease diagnosed.
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Early-stage symptoms can typically manifest either in the arms, legs, mouth, or respiratory system. Symptoms include loss of grip, fatigue, difficulty swallowing, emotional changes, weight loss, and clumsiness and stumbling.
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Middle-stage symptoms involve muscle shrinkage, joint pain, difficulty moving, drooling, breathing issues, excessive yawning, and emotional distress.
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Advanced-stage symptoms mainly affect breathing, often leading to death. Patients require assistance with eating, speaking, and other activities as the disease progresses.
Consult our neurologist in Patiala if you are experiencing the above motor neurone disease symptoms and get treatment.
Treatment of MNDs
Present motor neurone disease treatments aim to slow the progression of the disease. There is no cure for the disease, and current FDA-approved therapies include Riluzole for middle-stage patients and Edaverone for early, rapidly progressing cases. Other treatments focus on symptomatic relief, such as Botox Injections and Baclofen for muscle cramps and stiffness, Non-steroidal Anti-inflammatory Drugs (NSAIDs) for pain, Scopolamine for drooling, and Antidepressants.
Physical therapy, dietary changes, and assistive devices help manage daily functions. In some cases, Speech and Language Therapy can aid communication and swallowing. In end-stage cases, hospice care is usually recommended to ensure patient comfort and dignity during the final stages.
Consult our neurology hospital in Patiala if you need motor neurone disease treatment.
Conclusion
Comprehensive research is ongoing on treating MND disease, particularly through advanced methods like stem cells and gene therapies5,6. Existing and novel therapies have shown great potential, offering new hope in slowing disease progression.
At Manipal Hospitals, our neurologists are dedicated to providing cutting-edge treatments and personalised care to improve the lives of those diagnosed with MNDs. If you or your loved ones show signs or symptoms of MND, seek immediate consultation with our expert neurologists at Manipal Hospitals, Patiala, to receive prompt and timely treatments.
FAQ's
Outlook for patients diagnosed with an MND can vary, with life expectancy after diagnosis typically ranging from one to five years. The disease gradually worsens over time, and only a small number of people go beyond 10 years. Our neurologists will discuss the prognosis and available treatments that slow the progression of the disease
Specialists diagnose MND initially through medical history and physical examination, followed by a comprehensive neurological examination, which includes assessing motor and sensory function, thinking, coordination, etc. Tests like electromyography (EMG), nerve conduction studies, magnetic resonance imaging (MRI), and some genetic tests can help identify MNDs.
Most MNDs occur sporadically. Therefore, following certain lifestyle practices and taking care of your well-being can reduce some risks, which include maintaining a healthy lifestyle, avoiding smoking and chewing tobacco, minimising exposure to environmental toxins, limiting alcohol consumption, and performing genetic counselling if you have any family history of MND.
You can support your loved ones diagnosed with MND by helping them with everyday tasks, exercising, listening to them, being patient, and staying as normal as possible. Moreover, you can learn more about the disease and be aware of new symptoms that may occur over time. Patients with MND can also develop anxiety and depression, and it is necessary to get the necessary help from a specialist.
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