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Clinical features of motor neurone disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Presentation of motor neurone disease depends on the particular pathways involved:

  • combined upper and lower motor neurone features are present in 65% of cases
  • bulbar features are present in 25%
  • muscle weakness and atrophy are present in 10%

Features usually develop gradually. The initial complaint is often non-specific, e.g. a weakening hand grip.

Characteristic complaints:

  • hand - wasting, weakness, fasciculation
  • bulbar involvement - dysarthria and dysphagia
  • lower limb - weakness with spasticity
  • difficulty in breathing

Characteristic negative features:

  • no sensory loss or cognitive loss c.f. MS
  • sphincters are never affected } c.f. myasthenia
  • ocular muscles are never affected } gravis

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