Clinical update

Motor neurone disease

Motor neurone disease describes a group of related diseases, affecting the neurones in the brain and spinal cord.

Essential facts

The National Institute for Health and Care Excellence published guidance on MND in February. It recommends a range of health and social care professionals be involved at every stage of care, enabling decisions to be tailored to individual needs.

Picture credit: SPL

MND can be difficult to diagnose because it affects each person differently. There is no definitive set of symptoms or specific diagnostic test, which means other conditions need to be eliminated first. Early symptoms can include mild weakness, such as loss of dexterity, falls and trips, muscle wasting, twitching, cramps and stiffness, slightly slurred speech, or breathing and swallowing problems. There may also be cognitive changes. Although there is currently no cure, symptoms can be managed.

There is evidence suggesting the incidence of MND is increasing, but this might be due to more accurate testing,

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Essential facts

The National Institute for Health and Care Excellence published guidance on MND in February. It recommends a range of health and social care professionals be involved at every stage of care, enabling decisions to be tailored to individual needs.

Picture credit: SPL

MND can be difficult to diagnose because it affects each person differently. There is no definitive set of symptoms or specific diagnostic test, which means other conditions need to be eliminated first. Early symptoms can include mild weakness, such as loss of dexterity, falls and trips, muscle wasting, twitching, cramps and stiffness, slightly slurred speech, or breathing and swallowing problems. There may also be cognitive changes. Although there is currently no cure, symptoms can be managed.

There is evidence suggesting the incidence of MND is increasing, but this might be due to more accurate testing, the Motor Neurone Disease Association says. There is no clear cause of MND, with each person affected by a different combination of triggers. In about 5% of cases there is a family history of either MND or frontotemporal dementia.

MND can affect any adult at any age, but most people who have the disease diagnosed are over 40, with the highest incidence between the ages of 50 and 70. Men are affected approximately twice as often as women, but this varies by MND type. In 2015, researchers at the University of Glasgow published a study that concluded soldiers in the UK armed forces were 50% more likely to develop MND than those who had never served.

Nurses can ensure patients have information and support at diagnosis or when they request it. Clinicians can offer people chances to talk about symptoms and disease progression at an early stage. They can ask individuals about their preferences for involving their relatives or carers. This helps patients to be involved in decisions about their care, before their abilities to communicate decline.


Expert comment

Anna Kent, clinical specialist, Bletchley Community Hospital, Milton Keynes

‘The publication of these guidelines is exciting and long-awaited. They provide a useful tool to ensure we are able to achieve the best possible care for people with MND. It is reassuring that the service we provide in Milton Keynes is very much in line with NICE guidelines, so we will be able to benchmark against the recommendations.

‘The guidelines provide advice on the best possible, co-ordinated, appropriate care – from the point of diagnosis and through the disease trajectory. They also demonstrate the type of care people with MND should be able to access, and therefore could be used to influence areas where this is not available.’


Find out more

Motor neurone disease: assessment and management (2016)

Brain and spine foundation

MND Association

Living with motor neurone disease

Information for nurses

Motor neurone disease – an overview (2012)

Motor neurone disease and military service: evidence from the Scottish Veterans Health Study (2015)

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