Motor Neuron Diseases

Treatment of Motor Neuron Diseases

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(you may not get all of the symptoms mentioned here) 

Prognosis varies depending on the type of MND and the age of onset.  Some MNDs, such as PLS, are not fatal and progress slowly.  Patients with SMA may appear to be stable for long periods, but improvement should not be expected.  Some MNDs, such as ALS and some forms of SMA, are fatal.

There is no cure or standard treatment for the MNDs.  Symptomatic and supportive treatment can help patients be more comfortable while maintaining their quality of life.

Medicines may help with symptoms:

Muscle relaxants such as baclofen, tizanidine, and the benzodiazepines may reduce spasticity. 

Glycopyrrolate and atropine may reduce the flow of saliva. 

Quinine or phenytoin may decrease cramps. 

Anticonvulsants and nonsteroidal anti-inflammatory drugs may help relieve pain, and other drugs can be prescribed to treat depression. 

Tranquilizers often help with sleeping problems. 

Some patients with PPS develop sleep apnea (a potentially life-threatening condition characterized by interruptions of breathing during sleep), which can be treated with decongestant therapy, assisted breathing at night, or surgery to remove any blockage to the airway. 

Panic attacks over fears of choking to death can be treated with benzodiazepines. 

Botulinum toxin may be used to treat jaw spasms or drooling. 

Amitriptyline and other anticholinergic drugs can help control excess drooling. 

Some patients may eventually require stronger medicines such as morphine to cope with musculoskeletal abnormalities or pain, and opiates are used to provide comfort care in terminal stages of the disease.

Physical therapy, occupational therapy, and rehabilitation may help to improve posture, prevent joint immobility, and slow muscle weakness and atrophy. 

Stretching and strengthening exercises may help reduce spasticity, increase range of motion, and keep circulation flowing. 

Some patients require additional therapy for speech, chewing, and swallowing difficulties. 

Applying heat may relieve muscle pain. 

Assistive devices such as supports or braces, orthotics, speech synthesizers, and wheelchairs may help some patients retain independence.

Proper nutrition and a balanced diet are essential to maintaining weight and strength. 

Some patients who cannot eat or swallow may require insertion of a feeding tube. 

Patients may also require assisted ventilation due to muscle weakness in the neck, throat, and chest.

ALS: The drug riluzole (RilutekĀ®), the only prescribed drug approved by the U.S. Food and Drug Administration to treat ALS, prolongs life by 2-3 months but does not relieve symptoms.  The drug reduces the body's natural production of the neurotransmitter glutamate, which carries signals to the motor neurons.  Scientists believe that too much glutamate can harm motor neurons and inhibit nerve signaling.

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