Diagnosis

MND Care Centre Website

Diagnosis of MND

Motor neurone disease can be difficult to diagnose as some other illnesses start with similar symptoms. You may at first be referred to a throat specialist, a rheumatism specialist or even a bone specialist Your GP may have asked a neurologist to see you. This doctor is a specialist in conditions of the nervous system.They will want you to describe what has happened and specifically, how and when the symptoms started. The neurologist will ask a lot of questions about your health, your family and so on.

The strength of your arms and legs and your reflexes will be checked. The sensation on your skin will be tested with a pin and tuning fork. All of these things build up a picture to establish a diagnosis of motor neurone disease.

The neurologist will then order appropriate tests which will be done at a later date.

There is not one specific test to identify motor neurone disease and the neurologist may ask for a number of tests to be done to rule out other illnesses. These may include:-

Blood tests

You may need to have a number of blood tests to rule out other conditions which may develop in a similar way to motor neurone disease.

Electromyography (EMG)

A doctor may suggest you need an EMG which measures the electrical activity of the nerves. You do not need to prepare for the test in any way however you are requested not to use any body creams or lotions 24hrs before the test. The test takes between 30 and 45 mins. At the start of the test small electrodes or needles are placed on the area to be tested.This may be the arms legs or tongue. A small electric stimulation is given to the nerves. You may feel a tingling sensation which some people find uncomfortable but not painful.Using computer technology the responses of the nerves and muscles are recorded. Part of the test may also involve the placing of a small needle electrode into a muscle through the skin. The activity of the muscle is then tested and sometimes played as sound through a speaker when the muscle is at rest and when you are asked to move it.

In motor neurone disease the nerve impulses fail to travel down the nerve well enough to stimulate the muscle to move properly. This may be noted in the EMG test and can help confirm a diagnosis of MND. The test occasionally identifies a condition which is similar to MND but treated differently. If the result is borderline or normal, it may be suggested that you have the test repeated in a few months time.

X Rays

These are taken to rule out other conditions such as spondylosis which may cause nerve problems similar to MND. This involves sitting or lying very still whilst the X ray is being taken. There are no specific things you need to do to prepare for an X ray although you may be asked to change from your outdoor clothes into a hospital gown for the X ray to be taken.

MRI scan

An MRI scan uses a strong magnetic field to produce a detailed picture of the tissues inside your body. It can show muscles, nerves and blood vessels and be useful in distinguishing MND from some other conditions. In MND the scan is usually normal.This test cannot be done if you have a pacemaker or some kinds of metal implants for medical reasons. You will be asked to lie on a couch which then moves into the scanner. This looks like a tunnel. The scan usually takes about 30mins to perform and the person taking the scan will be in a small room next to the scanner.It may be noisy inside the scanner and you may be given some earphones to wear.You do not need to prepare for the scan in any way and there are no after effects.

Lumbar puncture

This is a test where a sample of fluid is taken from the spinal canal where the nerves run. You do not need to prepare for the procedure in any way. You will be asked to lie on your side with your knees pulled up towards your tummy and your chin on your chest. The doctor will clean a small area of your lower back and then put some local anaesthetic into the area. You may now feel a pushing sensation. The doctor will then pass a needle through the numb part of your back and remove a small sample of fluid which bathes the brain and spinal cord. You replace this fluid in a few hours but about 10% of people get a low pressure headache during the next 24-48 hours.