What are the symptoms?
Early symptoms are mild and include stumbling due to weakness of the leg muscles, difficulty holding objects due to weakness of the hand muscles, slurring of speech or swallowing difficulties due to weakness of the tongue and throat muscles. In some instances people experience changes in their cognition and behaviour.
Emotional responses may be more easily triggered and the person with MND may be aware of laughing and crying more readily than previously.
Cramps and muscle twitching are also common symptoms.
The effects of MND - initial symptoms, rate and pattern of progression, and survival time after diagnosis - vary significantly from person to person. The average life expectancy after diagnosis is two to three years.
What remains unaffected by MND?
For most people with MND the senses of sight, hearing, taste, smell and touch are not affected.
Bladder and bowel
The bowels and bladder are not affected by the disease, although diet and exercise should be carefully monitored. In the PLS (Primary Lateral Sclerosis) form of MND some people experience urinary urgency.
Constipation can occur, especially when people become less mobile or have to change their diet due to swallowing difficulties.
How is MND diagnosed?
The diagnosis of MND is often clinically difficult, and sometimes it is necessary to review a person for some time before the diagnosis can be confirmed. A general practitioner may suspect a neurological problem and organise referral to a neurologist (a doctor who specialises in disorders of the nervous system).
Many other conditions can mimic motor neurone disease early in the disease. Diagnosis requires an expert neurological opinion and often a series of detailed investigations. Diagnosis may take some time to be established, although diagnosis may be confirmed rapidly by a neurologist.
The diagnosis can be assisted through a range of tests, including some which eliminate other conditions. Nerve conduction studies (NCS) involve analysing neural function by electrical stimulation of nerves and recording muscle activity. Often an Electromyograph (EMG) is used, in which a needle is inserted into various muscles to measure their electrical activity. This can assist with both diagnosis and prognosis.