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UMN in ALS - J. Neurology, Neurosurgery & Psychiatry.pdf (439.76 kB)

Occasional essay: upper motor neuron syndrome in amyotrophic lateral sclerosis

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posted on 2023-06-09, 20:11 authored by Michael Swash, David Burke, Martin R Turner, Julian Grosskreutz, Nigel LeighNigel Leigh, Mamede deCarvalho, Matthew C Kiernan
The diagnosis of amyotrophic lateral sclerosis (ALS) requires recognition of both lower (LMN) and upper motor neuron (UMN) dysfunction.1 However, classical UMN signs are frequently difficult to identify in ALS.2 LMN involvement is sensitively detected by electromyography (EMG)3 but, as yet, there are no generally accepted markers for monitoring UMN abnormalities,4 the neurobiology of ALS itself, and disease spread through the brain and spinal cord,.5 Full clinical assessment is therefore necessary to exclude other diagnoses and to monitor disease progression. In part, this difficulty regarding detection of UMN involvement in ALS derives from the definition of ‘the UMN syndrome’. Abnormalities of motor control in ALS require reformulation within an expanded concept of the UMN, together with the neuropathological, neuro-imaging and neurophysiological abnormalities in ALS. We review these issues here.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Journal of Neurology, Neurosurgery and Psychiatry

ISSN

0022-3050

Publisher

BMJ Publishing Group

Issue

3

Volume

91

Page range

227-234

Department affiliated with

  • BSMS Neuroscience Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2020-01-10

First Open Access (FOA) Date

2020-01-10

First Compliant Deposit (FCD) Date

2020-01-10

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