Motor Neuron Diseases (MND) - Classes, Symptoms, And Symptom Treatment

One of the longest-living survivors of the motor neurone disease (MND) is Stephen Hawking who was diagnosed at 21 years old

Motor neuron diseases (MND) are a group of neurological disorders that selectively affect motor neurons, the cells that control voluntary muscle activity including speaking, walking, swallowing, and general movement of the body. When we say neurological disorders we mean  is any disorder of the body nervous system. It is a case of structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves that can result in a range of symptoms. Some of these symptoms include paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain and altered levels of consciousness.There are many recognized neurological disorders, some relatively common, but many rare. They may be assessed by neurological examination, and studied and treated within the specialities of neurology and clinical neuropsychology.They are generally progressive in nature, and cause increasingly debilitating disability and, eventually, death.
In the most common classification, the term "motor neuron disease" applies to the following five disorders which affect either upper motor neurons (UMN) or lower motor neurons (LMN), or both:

Type	UMN degeneration	LMN degeneration
Amyotrophic lateral sclerosis (ALS)	yes	yes
Primary lateral sclerosis (PLS)	yes	no
Progressive muscular atrophy (PMA)	no	yes
Progressive bulbar palsy (PBP)	no	yes – bulbar region
Pseudobulbar palsy	yes – bulbar region	no

 Treatment

There is no cure for motor neurone disease, but treatment can help relieve symptoms and slow the progression of the disease. However, Riluzole has been the only medication that has demonstrated a survival benefit for people with motor neurone disease. Riluzole is thought to slow down the progressive damage to the motor neurone cells by reducing their sensitivity to the nerve transmitter glutamate.

In medical research, riluzole extended survival by two to three months on average, though this varied from person to person and the disease continued to progress even with riluzole treatment.

Side effects of riluzole are usually mild and commonly include nausea, tiredness and a rapid heartbeat.
Very rarely, riluzole has been known to damage the liver. People prescribed riluzole therefore need to have monthly blood tests for the first few months to check their liver is working properly. If you have had liver disease, riluzole may not be suitable for you.

Treating the symptoms

A range of treatments can relieve many of the symptoms of motor neurone disease and improve your quality of life.

Muscle cramps

Muscle cramps can be treated with a medication called quinine or with physiotherapy.
However, there are some uncertainties surrounding the use of quinine for muscle cramps. This is because there is a risk of side effects such as:

• hearing problems
• tinnitus – the perception of noise in one ear, both ears or the head
• vertigo – a sensation that you, or the environment around you, is moving
• vision problems

Therefore, quinine will usually only be used if the potential benefits are thought to outweigh the risks.

Muscle stiffness

Muscle stiffness, also known as spasticity, can be treated using medication such as baclofen to relax the muscles. Side effects may include increased weakness or tiredness.

Drooling

Drooling can be treated with a number of medications. One widely used medication is a hyoscine hydrobromide skin patch. It was originally designed to treat motion sickness, but has since proved useful in controlling symptoms of drooling.
Side effects of hyoscine hydrobromide are uncommon, but can include:

• drowsiness
• dizziness
• blurred vision

If you have any of these side effects, do not drive or operate complex or heavy machinery.
Amitriptyline, glycopyrrolate, atropine eye drops or botulinum toxin injections are alternative medicines that can also be used to control drooling.

Communication difficulties

Not everyone with motor neurone disease will have speech problems, but there's a lot of help for people who do. A speech and language therapist can teach you several techniques to make your voice as clear as possible.
As motor neurone disease progresses, you may need some sort of assistive technology to communicate. A range of communication aids is available. Your therapist can advise you about the most effective communication aids for you.

Swallowing difficulties

As motor neurone disease progresses, swallowing problems (dysphagia) may become so severe that you won't be able to eat and drink normally.
One widely used treatment for dysphagia is a thin feeding tube known as a percutaneous endoscopic gastrostomy (PEG) tube. A PEG tube is surgically implanted into your stomach through a small cut on the surface of the stomach. The feeding tube doesn't usually restrict your daily activities and you can continue to bathe and swim normally if you wish.

Pain relief

If you have pain caused by the condition (usually joint pain caused my muscle weakness), the type of painkiller recommended to control the symptoms will depend on how severe your pain is.
Mild to moderate pain can often be controlled using non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. More severe pain is very rare, but it can be treated using an opiate-based painkiller such as morphine.
In some cases, a type of medication called gabapentin is used. Gabapentin was originally designed to treat epilepsy, but it's also useful for treating pain. Typical side effects of gabapentin include drowsiness.

Read more from our sources

• http://www.nhs.uk/Conditions/Motor-neurone-disease 
• en.wikipedia.org/wiki/Motor_neuron_disease‎ 
• en.wikipedia.org/wiki/Amyotrophic_lateral_sclerosis 
• www.medicalnewstoday.com/articles/164342.php‎