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The spectrum of lower motor neuron syndromes
This review discusses the most important lower motor neuron syndromes. This relatively rare group of syndromes has not been well described clinically. Two subgroups can be distinguished: patients in whom motor neurons (lower motor neuron disease (LMND)) are primarily affected or motor axons and thei...
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| Published in: | Journal of neurology 2003-11, Vol.250 (11), p.1279-1292 |
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| container_issue | 11 |
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| container_title | Journal of neurology |
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| creator | VAN DEN BERG-VOS, R. M VAN DEN BERG, L. H VISSER, J DE VISSER, M FRANSSEN, H WOKKE, J. H. J |
| description | This review discusses the most important lower motor neuron syndromes. This relatively rare group of syndromes has not been well described clinically. Two subgroups can be distinguished: patients in whom motor neurons (lower motor neuron disease (LMND)) are primarily affected or motor axons and their surrounding myelin (multifocal motor neuropathy (MMN)), both leading to muscle atrophy and weakness. Both hereditary and sporadic forms of LMND have been described. The discussion of recent advances in the genetic knowledge of several hereditary forms of LMND may lead to a better understanding of the pathophysiology and the development of therapeutic strategies. By contrast, the pathogenesis of sporadic LMND is largely unknown. It is, therefore, difficult to consider the various sporadic forms of LMND, discussed in this review, as separate diseases. Because the diagnostic and therapeutic options may differ, it would seem rational to consider sporadic LMND as a spectrum of syndromes which can be distinguished from each other on the basis of clinical presentation.MMN is a lower motor neuron syndrome with presumed immunemediated pathogenesis. Evidence of motor conduction block on nerve conduction studies and a positive response to treatment with intravenous immunoglobulins (IVIg) are considered the most relevant criteria for the diagnosis of MMN. As it is treatable, it is important to distinguish MMN from LMND. Careful electrophysiological analysis in the search for conduction block is, therefore, required in all adult patients with pure lower motor neuron syndromes. For the individual patient, distinction between the various lower motor neuron syndromes is important as it enables the physician to provide adequate information over the disease course in LMND and to facilitate early treatment in MMN. |
| doi_str_mv | 10.1007/s00415-003-0235-9 |
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M ; VAN DEN BERG, L. H ; VISSER, J ; DE VISSER, M ; FRANSSEN, H ; WOKKE, J. H. J</creator><creatorcontrib>VAN DEN BERG-VOS, R. M ; VAN DEN BERG, L. H ; VISSER, J ; DE VISSER, M ; FRANSSEN, H ; WOKKE, J. H. J</creatorcontrib><description>This review discusses the most important lower motor neuron syndromes. This relatively rare group of syndromes has not been well described clinically. Two subgroups can be distinguished: patients in whom motor neurons (lower motor neuron disease (LMND)) are primarily affected or motor axons and their surrounding myelin (multifocal motor neuropathy (MMN)), both leading to muscle atrophy and weakness. Both hereditary and sporadic forms of LMND have been described. The discussion of recent advances in the genetic knowledge of several hereditary forms of LMND may lead to a better understanding of the pathophysiology and the development of therapeutic strategies. By contrast, the pathogenesis of sporadic LMND is largely unknown. It is, therefore, difficult to consider the various sporadic forms of LMND, discussed in this review, as separate diseases. Because the diagnostic and therapeutic options may differ, it would seem rational to consider sporadic LMND as a spectrum of syndromes which can be distinguished from each other on the basis of clinical presentation.MMN is a lower motor neuron syndrome with presumed immunemediated pathogenesis. Evidence of motor conduction block on nerve conduction studies and a positive response to treatment with intravenous immunoglobulins (IVIg) are considered the most relevant criteria for the diagnosis of MMN. As it is treatable, it is important to distinguish MMN from LMND. Careful electrophysiological analysis in the search for conduction block is, therefore, required in all adult patients with pure lower motor neuron syndromes. For the individual patient, distinction between the various lower motor neuron syndromes is important as it enables the physician to provide adequate information over the disease course in LMND and to facilitate early treatment in MMN.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-003-0235-9</identifier><identifier>PMID: 14648143</identifier><identifier>CODEN: JNRYA9</identifier><language>eng</language><publisher>Berlin: Springer</publisher><subject>Adolescent ; Adult ; Aged ; Amyotrophic lateral sclerosis ; Atrophy ; Biological and medical sciences ; Central Nervous System - pathology ; Child ; Child, Preschool ; Chronic illnesses ; Clinical Trials as Topic ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. 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M</creatorcontrib><creatorcontrib>VAN DEN BERG, L. H</creatorcontrib><creatorcontrib>VISSER, J</creatorcontrib><creatorcontrib>DE VISSER, M</creatorcontrib><creatorcontrib>FRANSSEN, H</creatorcontrib><creatorcontrib>WOKKE, J. H. J</creatorcontrib><title>The spectrum of lower motor neuron syndromes</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><description>This review discusses the most important lower motor neuron syndromes. This relatively rare group of syndromes has not been well described clinically. Two subgroups can be distinguished: patients in whom motor neurons (lower motor neuron disease (LMND)) are primarily affected or motor axons and their surrounding myelin (multifocal motor neuropathy (MMN)), both leading to muscle atrophy and weakness. Both hereditary and sporadic forms of LMND have been described. The discussion of recent advances in the genetic knowledge of several hereditary forms of LMND may lead to a better understanding of the pathophysiology and the development of therapeutic strategies. By contrast, the pathogenesis of sporadic LMND is largely unknown. It is, therefore, difficult to consider the various sporadic forms of LMND, discussed in this review, as separate diseases. Because the diagnostic and therapeutic options may differ, it would seem rational to consider sporadic LMND as a spectrum of syndromes which can be distinguished from each other on the basis of clinical presentation.MMN is a lower motor neuron syndrome with presumed immunemediated pathogenesis. Evidence of motor conduction block on nerve conduction studies and a positive response to treatment with intravenous immunoglobulins (IVIg) are considered the most relevant criteria for the diagnosis of MMN. As it is treatable, it is important to distinguish MMN from LMND. 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Prion diseases</subject><subject>Denervation</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Motor Neuron Disease</subject><subject>Motor neurone disease</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Pathogenesis</subject><subject>Spinal cord</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNpdkE1Lw0AQhhdRbK3-AC8SBD25OvuVZI9S_IKCl3petpsJtiTZupsg_fduaaAgDMxhnvdleAi5ZvDIAIqnCCCZogCCAheK6hMyZVJwyqTSp2QKQgJVQskJuYhxAwBlOpyTCZO5LBM5JQ_Lb8ziFl0fhjbzddb4XwxZ63sfsg6H4Lss7roq-BbjJTmrbRPxatwz8vX6spy_08Xn28f8eUGd5NBTp6s0tdV5XlRVoQtAtCsEJUUuleO2EkJzKSuOrtIFF2XNwaEGyS1CWYsZuT_0boP_GTD2pl1Hh01jO_RDNEX6n-dSJvD2H7jxQ-jSb4azkgnBlUgQO0Au-BgD1mYb1q0NO8PA7D2ag0eTPJq9R6NT5mYsHlYtVsfEKC4BdyNgo7NNHWzn1vHIKcFA5kr8AZIReRE</recordid><startdate>20031101</startdate><enddate>20031101</enddate><creator>VAN DEN BERG-VOS, R. 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Prion diseases</topic><topic>Denervation</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Motor Neuron Disease</topic><topic>Motor neurone disease</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Pathogenesis</topic><topic>Spinal cord</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VAN DEN BERG-VOS, R. M</creatorcontrib><creatorcontrib>VAN DEN BERG, L. H</creatorcontrib><creatorcontrib>VISSER, J</creatorcontrib><creatorcontrib>DE VISSER, M</creatorcontrib><creatorcontrib>FRANSSEN, H</creatorcontrib><creatorcontrib>WOKKE, J. H. 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M</au><au>VAN DEN BERG, L. H</au><au>VISSER, J</au><au>DE VISSER, M</au><au>FRANSSEN, H</au><au>WOKKE, J. H. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The spectrum of lower motor neuron syndromes</atitle><jtitle>Journal of neurology</jtitle><addtitle>J Neurol</addtitle><date>2003-11-01</date><risdate>2003</risdate><volume>250</volume><issue>11</issue><spage>1279</spage><epage>1292</epage><pages>1279-1292</pages><issn>0340-5354</issn><eissn>1432-1459</eissn><coden>JNRYA9</coden><abstract>This review discusses the most important lower motor neuron syndromes. This relatively rare group of syndromes has not been well described clinically. Two subgroups can be distinguished: patients in whom motor neurons (lower motor neuron disease (LMND)) are primarily affected or motor axons and their surrounding myelin (multifocal motor neuropathy (MMN)), both leading to muscle atrophy and weakness. Both hereditary and sporadic forms of LMND have been described. The discussion of recent advances in the genetic knowledge of several hereditary forms of LMND may lead to a better understanding of the pathophysiology and the development of therapeutic strategies. By contrast, the pathogenesis of sporadic LMND is largely unknown. It is, therefore, difficult to consider the various sporadic forms of LMND, discussed in this review, as separate diseases. Because the diagnostic and therapeutic options may differ, it would seem rational to consider sporadic LMND as a spectrum of syndromes which can be distinguished from each other on the basis of clinical presentation.MMN is a lower motor neuron syndrome with presumed immunemediated pathogenesis. Evidence of motor conduction block on nerve conduction studies and a positive response to treatment with intravenous immunoglobulins (IVIg) are considered the most relevant criteria for the diagnosis of MMN. As it is treatable, it is important to distinguish MMN from LMND. Careful electrophysiological analysis in the search for conduction block is, therefore, required in all adult patients with pure lower motor neuron syndromes. For the individual patient, distinction between the various lower motor neuron syndromes is important as it enables the physician to provide adequate information over the disease course in LMND and to facilitate early treatment in MMN.</abstract><cop>Berlin</cop><pub>Springer</pub><pmid>14648143</pmid><doi>10.1007/s00415-003-0235-9</doi><tpages>14</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Amyotrophic lateral sclerosis Atrophy Biological and medical sciences Central Nervous System - pathology Child Child, Preschool Chronic illnesses Clinical Trials as Topic Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Denervation Disease Progression Female Humans Infant Infant, Newborn Male Medical prognosis Medical sciences Middle Aged Motor Neuron Disease Motor neurone disease Neurology Neurosciences Pathogenesis Spinal cord |
| title | The spectrum of lower motor neuron syndromes |
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