Motor neurone disease

• Published in: BMJ (Online) 2014-07, Vol.349 (jul09 1), p.g4052-g4052
• Main Authors: Nageshwaran, Saiji, Davies, Lucy Medina, Rafi, Imran, Radunović, Aleksandar
• Format: Article
• Language: English
• Subjects: Amyotrophic lateral sclerosis; Assisted suicide; Caregivers - psychology; Court decisions; EASILY MISSED?; Female; Hospice Care - psychology; Humans; Male; Motor Neuron Disease - psychology; Motor Neuron Disease - therapy; Palliative Care - psychology; Professional-Family Relations; Professional-Patient Relations; Right to die; Terminal Care - psychology
• ISSN: 0959-8138; 1756-1833; 1756-1833
• DOI: 10.1136/bmj.g4052

The diagnosis is a difficult clinical one, and rates of misdiagnosis are high outside motor neurone disease specialist centres. [...]it is recommended that if motor neurone disease is suspected, doctors refer urgently directly to someone with a special interest in the disease. Riluzole, a glutamate release antagonist, and non-invasive ventilation are currently the only treatments for motor neurone disease approved by the National Institute for Health and Care Excellence. 7 A Cochrane review (four randomised controlled trials involving 1477 patients) concluded that riluzole probably prolongs survival by two or three months 8 ; another Cochrane review (one randomised clinical trial, 41 patients) suggests that non-invasive ventilation prolongs survival (perhaps by many months) and improves or maintains quality of life in those with better bulbar function. 9 GPs have an important role as care coordinators once the diagnosis is made.