Occasional essay: upper motor neuron syndrome in amyotrophic lateral sclerosis

Swash, Michael, Burke, David, Turner, Martin R, Grosskreutz, Julian, Leigh, P Nigel, deCarvalho, Mamede and Kiernan, Matthew C (2020) Occasional essay: upper motor neuron syndrome in amyotrophic lateral sclerosis. Journal of Neurology, Neurosurgery and Psychiatry, 91 (3). pp. 227-234. ISSN 0022-3050

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Abstract

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.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
Subjects: R Medicine > RC Internal medicine > RC0321 Neurosciences. Biological psychiatry. Neuropsychiatry > RC0346 Neurology. Diseases of the nervous system Including speech disorders
Depositing User: Patricia Butler
Date Deposited: 10 Jan 2020 08:34
Last Modified: 11 Mar 2020 12:51
URI: http://sro.sussex.ac.uk/id/eprint/89267

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