What is MND?

What is MND?

 

Motor Neurone Disease (MND) also referred to as ALS (Amyotrophic Lateral Sclerosis) or Lou Gehrig’s disease, is a group of uncommon neurodegenerative diseases which affects the nerves (motor neurones) in the brain and spinal cord that causes rapidly progressive muscle weakness over time.

The motor nerves (motor neurones)—which are the “electrical wiring” in our body—sends signals from the brain and spinal cord to our muscles, telling the muscles what to do for movements. As MND progresses, it disables these biological functions for response and the nerves degenerate or “die-off” prematurely which causes rapid muscle weakness. There are four main types of MND.

Symptoms may include:

 

1. muscle weakness and paralysis,
2. impaired speaking,
3. swallowing, and
4. breathing.

Symptoms usually follow a pattern in three stages (depending on the progression in each person):

 

1. Initial Stage,
2. Advanced Stage, and
3. End Stage.

Progression is generally rapid and is variable with an average life expectancy from three to five years (or occasionally longer) from the onset of symptoms. There is no direct cause of pain or discomfort from MND but there may be several indirect causes of muscle spasms and cramps, stiff joints, and other bedridden symptoms as people with MND often stay in bed. Learn more about the symptoms and effects of MND.

The impact on the MND community is usually measured by the Incidence and Prevalence of the disease.

 

1. Incidence: The number of new cases added in a defined period, usually a year which is 2 per 100,000 of the total population
2. Prevalence: The number of cases existing at any point in time, around 6 per 100,000 of the total population.

Research has found that the incidence is higher in people aged over 50 years. Only 10% of cases are familial (inherited), while the remaining 90% are sporadic (random and isolated instances without any identifiable causes).

Although classified as a “Rare Disease” based on its prevalence, MND is quite common with approximately 140,000 new cases diagnosed worldwide each year, that is 384 new cases daily.

With the global statistics and the population in Malaysia, it is estimated there are probably more than 2,000 Malaysians with MND and 600 newly diagnosed cases every year, which is around 50 Malaysians diagnosed with MND every month, whereby men are more susceptible compared to women.

Scientists around the world have yet to identify causes or cures for MND. However, they believe that significant treatment breakthroughs are possible.

 

What are the symptoms and effects of MND?

Symptoms vary for each person, and it is unlikely to develop all at once, or in any specific order. It depends on the pattern of the motor neurones involved and the part of the body where the symptoms begin.

As the disease progresses, symptoms are likely to affect different parts of the body. The effects of MND are from the impairment of the parts of the body affected by the disease that triggers other issues not caused directly by the disease.

Usually, sensations such as taste, smell, touch, and feeling hot or cold are not affected by the disease.

 

Common symptoms of MND include:

 

• Muscle weakness & wasting. Muscle weakness and deterioration of the upper limbs (arms) or lower limbs (legs) like muscle stiffness, cramps, and fasciculation (twitching). This results in tripping while walking, dropping or losing grip of objects.
• Slurring of speech and swallowing difficulties. Excessive salivation, slurring, and swallowing can occur due to weakness, wasting, and stiffness of the tongue and throat muscles.
• Breathing difficulties. A weakness of the respiratory muscles decreases lung capacity. A person may experience unrefreshing sleep, morning headaches, and excessive daytime tiredness.
• Fatigue. People often complain of tiredness caused by any of the following:
  • muscle exhaustion & spasticity (muscle remains contracted/stiff/tight and resists being stretched, which affects movement),
  • reduced stamina (due to a decrease in lung capacity),
  • weight loss,
  • metabolic changes,
  • and reduced food intake.

 

Effects of MND include:

 

• Pain and discomfort. Motor neurones don’t transmit pain signals which means there is no direct cause of pain. However, muscle stiffness, spasms, and cramps can cause discomfort due to restricted mobility. This discomfort may be relieved by continually changing the sitting/sleeping posture, massaging the muscles and gentle exercise for stiff joints.
• Excessive saliva. As the throat muscles weaken, some people may struggle to swallow, causing saliva pooling or excessive saliva in the mouth and an increased risk of choking due to excess saliva.
• Bowel problems. There is no direct cause of the disease. However, constipation may occur due to restricted mobility, weak abdominal muscles, and altered diet and fluid intake. Diarrhoea can sometimes happen with a severely constipated bowel.
• Cognitive and behavioural changes. Up to 50% of people with MND may experience changes in cognition, language, behaviour, and personality, such as the difficulties with memory, learning, language and low concentration. Behavioural changes may include egocentric or selfish behaviour, apathy, irritation, loss of interest, recklessness, aggression and absence of insight into these changes. They may also find it challenging to recognise emotions in others and have altered sensitivity to social and emotional cues.

 

There are different types of MND?

There are four main types of MND, each depending on the pattern of the motor neurones involved and the part of the body where symptoms begin. There can be an overlap between the various types. The onset of symptoms varies for each individual and each affecting the person differently.

Motor Neurones are a type of nerve cell that sends messages around the body for motor functioning. There are two main kinds of motor neurones:

 

1. Upper Motor Neurones (UMN): that are in the brain and runs through the spinal cord to send messages to the peripheral nerves.
2. Lower Motor Neurones (LMN): that are in the peripheries after exiting the spinal cord and they transmit messages from the brain to the muscles.

 

The difference between the four main types of MND: