Prevention, Diagnosis and Treatment of Motor Neuron Disease

Motor Neuron Disease happens when upper and/or lower nerve systems are degraded over time, as the result a wide variety of symptoms appears. Common symptoms are spinal muscular atrophy, progressive bulbar palsy (PBP), primary lateral sclerosis (PLS), progressive muscular atrophy (PMA), and amyotrophic lateral sclerosis (ALS). Post-polio syndrome is a motor neuron disease that can develop years after the individual was infected with polio virus.

Motor neurons are nerves inside our body that transmit impulse for physical movements, including walking, running, speaking and even breathing. People with motor neuron disease progressively lose the ability to transmit certain messages, making common movements slower and more difficult. In more severe cases, death can occur.

Sometimes, motor neuron disease is inherited but in most cases, people develop this condition without any prior family history. It occurs worldwide and each type of disease has its own frequency, it’s believed that 5 per 100,000 people are affected. For example amyotrophic lateral sclerosis (ALS) is a very common motor neuron disease and about 30,000 Americans have this disease. ALS commonly affect men between 40 and 70, however on older age groups, it is more equally distributed between both genders.

Motor neurons carry nervous system messages from the brain to the brain stem (via the upper motor neurons) and eventually to the spinal cord (via the lower motor neurons). When the message reaches the muscle, movements are created. However, these “information highways” can disrupt signal transmissions, which affect a person’s ability to control muscles voluntarily (controllable movements). This can affect common activities such as swallowing, breathing and walking, however it doesn’t affect involuntary muscles movement, such as heartbeat. Eventually, voluntary muscles can become smaller and weaker (atrophy). In a few cases, it can result in paralysis and in more severe cases, death, because the person can no longer breathe properly. Motor neuron disease has different symptoms, however it can be different based on the type:

• Emotional changes

• Difficulty breathing, swallowing or speaking

• Fasciculation (muscle twitching)

• Muscles cramping or stiffness

• Fatigue

• Poor muscle coordination, the person may stumble easily or have problem buttoning shirts.

Sensory nerves responsible for taste, hearing and smell are not affected by motor neuron disease nor other essential body functions such as bowel and bladder movements. Experts still can’t determine the cause of non-inherited motor neuron disease, but it can be caused by lifestyle, exposure to certain environment agents, such as virus and toxins. There is a promising result from a research, Neuropathy Target Esterase (NTE) is strongly believed to encourage the motor neuron disease development. Studies are being performed to evaluate the interaction between environmental and genetic factors for the development of this condition.

Prevention

Environmental factors are suspected to cause non-inherited motor neuron disease, however this is still an often debated topic, as researches still can’t provide strong evidences. Experts are still examining the underlying causes of this condition. Your best chance to prevent the condition is by removing as much as toxins in your environment as possible, improving hygiene and adopting a healthy lifestyle.

Diagnosis

Because many symptoms of motor neuron disease are similar to other conditions and diseases, the diagnosis process can be somewhat complicated. If a person is suspected to have motor neuron disease, it’s important to immediately seek advices from doctors and other qualified medical professionals. Common tests for diagnosing motor neuron disease are:

• Neurological examinations

• EMG (Electromyography) involving muscles stimulation using electric impulses to for physical abnormalities

• NCV (Nerve Conduction) test

• Myelogram

• Spinal tap

• MRI (Magnetic Resonance Imaging) to detect abnormalities on the brain and spinal column

• Urine and blood tests to determine heavy metal, hormone and protein levels

Doctors will also ask for a complete medical record to determine when the symptoms first occurred. It will provide some clues on whether symptoms are caused by other diseases. It is necessary for patients to list all information he can provide to speed up the diagnosis process.

Treatment

Unfortunately, the medical community still can’t provide real cure for motor neuron disease, as there are still no solid proof on the real cause of the disease. Current treatments are focused on alleviating the symptoms. A common medication for motor neuron diseases is Rilutek, which can slow down the disease progressions. Some drugs can also be administered to control muscle cramps and spasms, and also other symptoms.

During the treatment, it is important for the patient to maintain a nutritionally balanced intake and reasonable calorie intake. It is advisable to make an appointment with nutritionist to make necessary changes on dietary plan. Medical professionals may offer some advices to make life easier for people with motor neuron disease. People with motor neuron disease should be accompanied during a meal as the risk of choking is higher. Having family members or friends who can do Heimlich maneuver is important. On patients with dysphagia (difficulties in swallowing and chewing), eating can be a hard challenging. If the patient has significant trouble swallowing, it is recommended to use blender to change solid foods into thin liquids and if the patient also loses the ability to drink, it is necessary to insert a feeding tube into the abdomen wall.

Some treatment interventions can help patients to cope with challenge of living in debilitating conditions. It requires plenty of care from the health care professional team, including rehabilitation, physical and occupational specialists. Patients should get compassionate care to obtain the best quality of life possible throughout all illness stages, preserving enjoyment and mobility. Mental health specialists’ involvement shouldn’t be over-emphasized, as this diagnosis type can be especially challenging, sometimes requiring significant heroic coping skills. Certain patients don’t get counseling supports in the standard treatment program and it is imperative for care givers to take a more active role in obtaining necessary supports both for patients and themselves. Anxiety and depression are typical responses to distressing symptoms and assistances to help patients with this condition are of extreme importance. Caregivers shouldn’t be hesitant in requesting spiritual, emotional and mental assistances if necessary and resources are usually available through many organizations.

Because motor neuron disease is a lifelong condition, support and counseling should also be given to family members. There shouldn’t be any hesitancy in requesting support during challenging medical conditions. It is wise to get prepared for all possible scenarios when the patient has a poor prognosis, as the patient’s quality of life should still be honored. However, long term medical care for people with this condition is often expensive and it is necessary to ensure that the insurers will cover the expense. There are some alternative resources to assist people with financial concerns for example with the United States Social Security Administration or Medicare. Care givers should also contacts related support groups, to gain all necessary improvement.

The prognosis for patients with motor neuron disease varies on the type of affliction, the course of illness, the age and other individual factors, For example, most people with ALS may have a life expectancy of less than 5 years and about 30% of them can live longer than ten years. On rare cases, the disease progression can even stop. The condition should be considered as step-wise and caregivers should make adjustments to make life more comfortable and productive for the patient.

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