MND-ALS CLINICAL PRESENTATION

SUMMARY

1. present(s) with diffuse hyperreflexia, spasticity (UMN), fasciculations, weakness & atrophy (LMN).

2. Most striking feature: focal, symmetric onset of weakness which spreads to adjacent body & sensory sparing.

3. There may be mild spasticity (spastic dysarthria) making ambulation difficult and muscle cramping.

4. Patients may present to the GP with asymmetric limb weakness, dysphonia or dysphagia and may be presumed to have an isolated disorder of the PNS leading to delay in diagnosis.

5. assoc. with frontotemporal dementia.

6. Sensation, bowel and bladder function & voluntary eye movements are spared.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].