Motor Neurone Disease

Motor neurone disease (MND) is the name given to a group of diseases in which the nerve cells (neurones) controlling the muscles that enable us to move, speak, breathe and swallow undergo degeneration and die.

HISTORY

A 76 year old man (GH), referred by a private consultant with weakness below the knees, slowed speech and swallowing difficulty over several months and a recent episode of three falls in one week, with sensory loss below the knees and calf cramping

GH was normally physically active, travelling with his wife in their caravan and walking daily.

EXAMINATION

GH had slow, slurred speech, some visual dependence for balance and slow gait speed when compared to age-appropriate levels. Mild leg weakness was assessed, with significant loss of coordination on the right side of his body.

These findings were conveyed to the referring specialist, with GH undergoing further tests. GH was reviewed in between caravan trips to monitor function. Three months later, at a follow up appointment, GH's physical function had rapidly declined. Urgent private Neurology appointment was made and multiple tests performed. GH was diagnosed with Motor Neurone Disease.

TREATMENT

Initial treatment involved maintaining muscle length, dynamic balance and safe gait. Advice was given regarding mobility and adaptive aids to maximise safety when walking, and GH and his wife were able to liaise directly with a supportive equipment company.

As function declined, treatment has focussed on teaching safe transfer techniques, showing GH's wife how to assist where necessary. Manual therapy and maintenance of range of motion have been used to prevent contractures, and maintain posture. Progress reports have been provided to GH's medical specialists.

OUTCOME

GH continues to be reviewed on a six weekly basis, to monitor progression of symptoms and safety. Supporting quality of life is of primary concern.