Motor neurone disease
Mixed upper and lower motor neurone signs without sensory loss, the mimics you must exclude (multifocal motor neuropathy, cervical myelopathy, Kennedy disease), EMG and Gold Coast criteria, riluzole, tofersen for SOD1, and timing NIV and gastrostomy.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Progressive degeneration of upper and lower motor neurones. ALS is the commonest form; MND is the umbrella term used in Australia.
- Incidence about 2 per 100,000 per year, peak 55 to 75. Median survival is 2 to 4 years from symptom onset, mostly from respiratory failure.
- About 10% is familial. C9orf72 repeat expansion is the commonest genetic cause, then SOD1, TARDBP and FUS.
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Sources
- Motor neurone disease: assessment and management (NG42)National Institute for Health and Care Excellence, 2016, updated 2019
- European Academy of Neurology (EAN) guideline on the management of amyotrophic lateral sclerosis in collaboration with ERN EURO-NMD (Van Damme P et al. Eur J Neurol 2024;31(6):e16264)European Academy of Neurology, 2024
- Protocol for the development of the Australian Motor Neurone Disease (MND) Guideline (Stern C et al. Clin Public Health Guidel 2026;3(1):e70055)AU/NZClinical and Public Health Guidelines, 2026 (protocol; guideline in development)
- A proposal for new diagnostic criteria for ALS (Gold Coast criteria; Shefner JM et al. Clin Neurophysiol 2020;131(8):1975-1978)Clinical Neurophysiology, 2020
- Trial of antisense oligonucleotide tofersen for SOD1 ALS (VALOR; Miller TM et al. N Engl J Med 2022;387:1099-1110)New England Journal of Medicine, 2022
- Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND) (Miller RG et al. Cochrane Database Syst Rev 2012;(3):CD001447)Cochrane, 2012
- Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis (Bourke SC et al. Lancet Neurol 2006;5:140-147)The Lancet Neurology, 2006
- Gastrostomy in patients with amyotrophic lateral sclerosis (ProGas): a prospective cohort study (ProGas Study Group. Lancet Neurol 2015;14(7):702-709)The Lancet Neurology, 2015
- Global best practice recommendations for genetic counselling and testing in amyotrophic lateral sclerosis (Salmon K et al. Brain 2026;awag375)Brain, 2026
- PBS Schedule: riluzole, edaravone and tofersen (amyotrophic lateral sclerosis)AU/NZPharmaceutical Benefits Scheme, Checked November 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback