Neurology · UKMLA & AKT
Motor neurone disease
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise motor neurone disease — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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