MND

Question 1

Which one of the following statements regarding MND is NOT correct?
a. Progressive muscular atrophy is a variant of MND.
b. MND is characterised by rapidly progressive neuronal degeneration.
c. The condition involves upper motor neurons.
d. The condition involves lower motor neurons.

Answer 1

Answer: b
MND is characterised by SLOW progressive degeneration of motor neurons.

• (a) Progressive muscular atrophy = Lower motor neuron.

Question 2

Which one of the following statements regarding the pathophysiology of MND is NOT correct?
a. There is degeneration in the ventral horns of the spinal cord.
b. The affected neurons are innervated by the spino-thalamic tract.
c. There may be associated brain atrophy in the frontal lobes.
d. There is atrophy of the ventral nerve roots.

Answer 2

Answer: b
The affected neurons are innervated by the CORTICO-SPINAL TRACT.

Question 3

Which one of the following statements regarding MND is NOT correct?
a. Onset is usually between 40 and 60 years of age.
b. Apoptosis (programmed cell death) may play a role.
c. There is a family history in the majority of cases.
d. Exogenous factors such as toxins and viruses may play a causative role.

Answer 3

Answer: c
Only 10% familial ethology.
90% of causes are sporadic.

• pg. 7-8

Question 4

Which one of the following additional signs and symptoms would be UNLIKELY in this patient (suspected MND)?
a. Staccato speech
b. Twitching of the tongue
c. Choking during meals
d. Wasting of hand muscles

Answer 4

Answer: a
Slurred speech NOT staccato speech
* Staccato speech = MS / Stroke

• Bulbar symptoms = Slurred speech, choking during meals, wasting and twitching of the tongue.
• Cervical symptom = Wasting of hand muscles.
• Upper and Lower Motor Neuron signs in 3 regions = bulbar, cervical, thoracic, lumbosacral (definite)

Question 5

Which one of the following would one NOT expect to find on neurological examination?
a. Muscle atrophy and fasciculation
b. Extensor plantar response
c. Loss of deep tendon reflexes
d. Sensory losses

Answer 5

Answer: d

Atypical signs:
* Sensory loss
* Extrapyramidal dysfunction
* Extraocular muscle
* Autonomic dysfunction
* Abnormal sphincter control