BMJ  2008;336:658-662 (22 March), doi:10.1136/bmj.39493.511759.BE

Clinical Review

Diagnosis and management of motor neurone disease

¹ Sheffield Care and Research Centre for Motor Neurone Disorders/Academic Neurology Unit, Section of Neuroscience, University of Sheffield, Sheffield S10 2RX

The first 150 words of the full text of this article appear below.

Motor neurone disease is a devastating illness which leads to progressive paralysis and eventual death. We will discuss the presentation of motor neurone disease in primary care and update non-specialists on progress with regards to life prolonging interventions, better control of disease symptoms, and an increased understanding of disease mechanisms. Motor neurone disease is rare but patients often are aware of it, so this review should help non-specialists reassure patients in whom it is unlikely to be the diagnosis.

Sources and selection criteria

The review is based on our experience in running the Sheffield Care and Research Centre for Motor Neurone Disorders and an up to date review of the current literature relating to motor neurone disease. Searches used PubMed and the Cochrane Library databases.

How common is motor neurone disease?

Motor neurone disease is relatively uncommon with an annual incidence of 2 in 100 000 and prevalence of 5-7 per 100 000.^{1 2 3} General practitioners can expect to see one . . . [Full text of this article]

How does motor neurone disease present?

Box 1 Diagnostic pointers in primary care for limb onset motor neurone disease

How is motor neurone disease diagnosed?

Box 2 Diseases mimicking motor neurone disease
Giving the diagnosis—a personal view
Box 3 Common questions asked by patients on receiving a diagnosis of motor neurone disease

What life prolonging interventions are available?

Riluzole
Respiratory care
Antioxidants

What supportive interventions are available?

Nutrition and feeding
Multidisciplinary team
End of life care
Future treatments
Box 4 Recent promising advances in motor neurone disease
TDP-43
Role of microglial and astrocytes
Gene studies
Conclusion
Summary points
Additional educational resources

Rapid Responses:

Read all Rapid Responses

Incidence of MND varies with geography-commissioners take notice

Mohamed Sakel
bmj.com, 24 Mar 2008 [Full text]