Neurology · UKMLA & AKT
Motor neurone disease
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- MND (most commonly ALS) causes simultaneous UMN and LMN degeneration - the co-existence of both is the diagnostic hallmark.
- Bulbar onset (~25-30%) - dysarthria, dysphagia (liquids before solids - early LMN pharyngeal weakness), hypophonic/nasal speech
- Tongue fasciculations and wasting - key LMN bulbar sign
- Brisk jaw jerk - UMN sign; alongside tongue wasting strongly supports bulbar MND
- Limb onset (~70%) - asymmetric distal upper limb wasting, foot drop
- Muscle wasting and fasciculations - hands, shoulders, thighs
- Spasticity and hyperreflexia - UMN features co-existing with LMN wasting
- Eye movements characteristically spared - no ptosis, no ophthalmoplegia until very late
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