All clients with neurological deficits affecting movement including:
What is Motor Neurone Disease?
Motor Neurone Disease (MND) is a progressive neurodegenerative disease that attacks the upper and lower motor neurones.
Degeneration of the motor neurones leads to weakness and wasting of muscles, causing increasing loss of mobility in the limbs, and difficulties with speech, swallowing and breathing. back to the top
Symptoms of Motor Neurone Disease
It is important to realise not every symptom you experience will be caused by MND. You may have another problem, which requires medical attention so please speak to your GP. Equally you may have a symptom related to the MND that is not listed here, the disease will affect everyone individually, so again it is important to speak to your GP who may be able to help relieve your symptoms. back to the top
Pain
Pain and discomfort are not caused directly by the MND but may have several indirect causes. Your GP should be able to prescribe a suitable painkiller. back to the top
Muscle cramps and spasms
May be relieved by changing position when relaxing in a chair or bed. If this is not helpful your doctor may be able to provide a muscle relaxant. back to the top
Stiff joints
Can be helped with gentle exercise (consult a physiotherapist). back to the top
Incontinence
Incontinence is not a direct cause of the MND, though lack of moblility may mean accidents occur. The occupational therapists and specialist nurses can advise you if this is a problem. back to the top
Bowel problems
The bowel may become constipated due to restricted mobility and/or changes to diet. Increasing fluid and fibre may help, or ask your doctor to prescribe a laxative. Diarrhoea may be the overflow from a severely constipated bowel. Ask your district nurse or GP for advice. back to the top
Saliva and mucous
When swallowing becomes a problem an excess of saliva may pool in the mouth, or it may become thick and sticky. In both cases your GP will be able to prescribe medication to help. (See InfP3 Saliva Control (186 kb) )
Coughing and feeling of choking
These may occur as a result of food or saliva becoming lodged in the airway, a speech therapist can teach you techniques to help manage these episodes. back to the top
Breathing
Eventually the breathing muscles will become affected by the MND. When this happens you will need a breathing assessment from a respiratory consultant. Please refer to Inf14A Understanding how MND might affect your breathing (122 kb) for more information. back to the top
Cognitive changes
For most people there will be no cognitive involvement, however approximately 20% of people will undergo some degree of difficulty or personality change. This may be very mild and will probably go un-noticed, but for others the personality change may be quite marked. back to the top
Diagnosing Motor Neurone Disease
The diagnosis of MND is a clinical one, established by a neurologist on the basis of history and neurological examination. There is no diagnostic test for MND. Investigations such as blood tests, electromyography (EMG), magnetic resonance imaging (MRI), and sometimes genetic testing are useful to rule out other disorders that may mimic MND. However, the diagnosis of MND remains a clinical one. Having excluded other diseases, a relatively rapid progression of symptoms is a strong diagnostic factor. Although an individual's progression may sometimes "plateau", it will not improve.
A set of diagnostic criteria called the El Escorial criteria have been defined by the World Federation of Neurologists for use in research, particularly as inclusion/exclusion criteria for clinical trials. Owing to a lack of clinical diagnostic criteria, some neurologists use the El Escorial criteria during the diagnostic process, although strictly speaking this is functionality creep, and some have questioned the appropriateness of the criteria in a clinical setting. back to the top
Courtesy of Motor Neurone Disease & Wikipedia
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