Motor Neuron Disease (MND) usually starts with subtle weakness, often in the limbs (hands/legs causing grip issues, stumbling) or the throat/tongue (slurred speech, swallowing difficulty), but can begin in different areas, affecting muscles for talking, breathing, or walking. It typically progresses slowly, affecting one side first before spreading, with symptoms varying greatly between individuals, but commonly involving muscle cramps, stiffness, and fatigue.
The first signs of Motor Neurone Disease (MND) often involve muscle weakness, leading to stumbling, a weak grip, or difficulty lifting objects, but can also start with speech/swallowing issues (slurring, choking) or muscle twitching (fasciculations) and cramps. These symptoms are usually mild and painless initially, varying by where the motor neurons are first affected, but often include fatigue and affect limbs or speech/swallowing muscles.
Most people experience the onset of symptoms after the age of 40 years and MND is most common in people aged between 50 and 70 years. Although rare, for some people there is a genetic factor and they inherit from their family an increased risk of developing MND.
Beginning Stages of Motor Neurone Disease (MND)
Individuals may notice symptoms such as muscle weakness, twitching, or cramping, typically affecting one limb or a specific muscle group. These symptoms may initially be mild and intermittent, often mistaken for normal aging or fatigue.
In adults, MNDs are more likely to be sporadic, meaning the disease occurs with no family history. Symptoms typically appear after age 50, though onset of disease can occur at any age. While some MNDs are inherited, the causes of most MNDs are not known.
The exact cause of Motor Neurone Disease (MND) is unknown, but it's believed to result from a complex mix of genetic predisposition, environmental factors (like toxins or intense exercise), and lifestyle influences, with most cases being sporadic (no known cause) and only 5-10% being familial (inherited). Researchers are exploring potential triggers such as genetic mutations (like C9orf72, SOD1), heavy metals, pesticides, viruses, and issues with cellular waste disposal or nerve signaling.
Early signs of ALS often involve painless muscle weakness, such as tripping or dropping things, along with muscle twitching (fasciculations), cramping, and stiffness (spasticity), commonly starting in limbs but sometimes affecting speech (slurring) or swallowing (choking). Other early indicators include significant fatigue, poor balance, or even uncontrollable laughing/crying (pseudobulbar affect). These symptoms usually begin subtly in one area and spread, affecting daily activities before becoming severe.
Some of the more common conditions that can mimic MND include:
In 1963, while a graduate student at the University of Cambridge, Hawking began experiencing early symptoms of ALS, such as muscle weakness and slurred speech. These initial manifestations rapidly progressed, leading to a diagnosis that came with a grim prognosis—2 years to live.
The symptoms of MND begin gradually over weeks and months, usually only on one side of the body initially, and get progressively worse. Common early symptoms are: a weakened grip, which can cause difficulty picking up or holding objects. weakness at the shoulder that makes lifting the arm difficult.
Genetic factors are known to contribute to MND. In both men and women, motor neurons are dependent on testosterone for survival. Men are more likely than women to develop MND and are also exposed to higher levels of testosterone before birth.
Professor Hawking lived with motor neurone disease for 55 years having been diagnosed at the age of 21 while at university, a story told in the 2015 Oscar winning film The Theory of Everything.
The latency from symptom onset to diagnosis in MND documented in the literature has shown little improvement or change over the last 40 years and figures range from 10.6–17.5 months3–13.
Weakness. Progressive muscle weakness is a feature of MND, but can be variable in its severity, progression and distribution. In the lower limbs it may present as foot drop, a tendency to trip, difficulty in rising from chairs and excessive fatigue on walking.
stiff or weak hands – you may have problems holding or gripping things. weak legs and feet – you may find climbing stairs difficult, you may trip over a lot and you may find it hard to lift or move your foot (foot drop) twitches, spasms or muscle cramps (where muscles painfully tighten)
There's no single test for MND. Various tests might be used to rule out other possible causes of the your symptoms. Tests might include: blood tests – these can be used for several reasons, like checking that organs are working, or to look for a marker of muscle damage (creatinine kinase)
Stephen Hawking's "last warnings" focused on humanity's existential risks, urging us to become a multi-planetary species to survive threats like climate change, asteroids, and rogue artificial intelligence (AI). He warned that unchecked AI could surpass human intelligence, potentially replacing us, and emphasized the need to colonize other planets before Earth becomes uninhabitable due to self-inflicted or natural disasters, as detailed in his posthumous book Brief Answers to the Big Questions.
Vitamin B12 deficiency can mimic ALS, particularly in its presentation of weakness, numbness, and balance problems. Both conditions can affect the nervous system and lead to muscle weakness and neurological symptoms.
ALS is a progressive neurodegenerative disease that attacks motor neurons in the brain and spinal cord. This results in the wasting away of muscle, loss of movement, and eventual paralysis. The disease is 100% fatal, with most people living 3-5 years after diagnosis.
An MRI scan will not diagnose MND, because the damage caused by MND does not show up on this scan. It is a tool for eliminating other conditions that can mimic symptoms of MND.
Listed in the directory below are some, for which we have provided a brief overview.
Life expectancy for people with MS is only slightly reduced, however MND is life-shortening. For most people with MND, the average survival time following diagnosis is two and a half years and a minority of people living five years or more.
Nasal inspiratory pressure during a sniff (SNIP) is a respiratory test extensively promoted in Amyotrophic Lateral Sclerosis (ALS) for the assessment of the inspiratory muscle strength.
ALS often starts in the hands, feet, arms or legs. Then it spreads to other parts of the body. Muscles get weaker as more nerve cells die. This eventually affects chewing, swallowing, speaking and breathing.
The split hand index (SI), a simple and widely accessible neurophysiological measure is derived by dividing the product of the motor amplitudes recorded from the abductor pollicis brevis (APB) and first dorsal interosseous (FDI) muscles by the motor amplitude recorded from the abductor digiti minimi (ADM) muscle of the ...