Overview

(MND) affects motor neurons, the cells that control voluntary muscle movements such as eating, speaking, and walking. These may impact the motor neurons in the upper or lower limbs or both. The age at which a motor neuron disease first manifests and the part of the central nervous system that is affected determine the prognosis. There are various types of MND. Physicians categorise them based on the neurons they impact and whether or not they are inherited. Among them are: 

Amyotrophic lateral sclerosis (ALS): The most prevalent form of MND. It impacts both the upper and lower motor neurons of the brain and spinal cord, which in turn impact the respiratory system, arm, and leg muscles. 

Progressive muscular atrophy: About 10% of the cases of MND are thought to be caused by progressive muscular atrophy. Only the lower motor neurons in this type of MND degenerate, and the prognosis is longer than in ALS. Males are more likely than females to be impacted. 

Primary lateral sclerosis: This is a rare form of MND occurring in about 1%–2% of cases. Only the upper motor neurons are affected by this type of MND. Sometimes, MND initially presents as primary lateral sclerosis, but as time goes on, the lower motor neurons may become affected, leading to the diagnosis of ALS instead of MND.In true cases of primary lateral sclerosis, the condition progresses slowly and may not reduce life expectancy despite high disability levels. Muscle weakness, stiffness and increased reflex response are among the most common symptoms and signs.

Progressive bulbar palsy: Progressive bulbar palsy can occur in around 20% of MND cases. The medulla oblongata, located at the base of the brainstem, is referred to as the "bulbar" region. One kind of MND is progressive bulbar palsy, which is characterised by the degeneration of both upper and lower motor neurons in that region. The tongue, pharynx, and larynx—collectively referred to as the bulbar muscles—are innervated by these motor neurons, which is why progressive bulbar palsy symptoms include wasting, tongue weakness or stiffness, trouble speaking and swallowing and issues with salivary thickness or amount.

Causes

Approximately 10% of cases of MND are inherited. Although the cause of the remaining 90% of MND patients is unknown, a combination of hereditary and environmental factors is thought to be responsible.

Symptoms

Initially, MND typically affects one or more of the following body parts' muscles, resulting in the following symptoms: 

• Hands or arms: weakness in the arms, trouble dressing, gripping objects, and fine motor skills for eating, writing,  buttoning shirts,  pushing lift buttons, and taking care of oneself 

• Legs and/or ankles: Dragging the foot, stumbling, and falling 

• Breathing: Dyspnea during mild exertion, like speaking 

• Poor quality sleep 

• Throat and tongue: choking, drooling, slurred speech, and swallowing issues 

Additional body parts become impacted over time. When MND reaches an advanced stage, all of these can happen in any order and cause severe physical disabilities. While some MND patients may experience dementia or "fog in the brain ", about half of MND patients maintain clear thinking and full awareness of their condition throughout their illness. The senses of nerves that govern taste, touch, hearing, smell and sight are unaffected.

Ayurvedic View

snayu gata vata - Due to the following of nidana (causes that aggravate vata dosha), this vikruta prakupita (aggravated), vyana vata dosha takes sthana samshraya (settles in), snayu (which is connected to motor movements, which causes twitching pain and diseases affecting ekanga (part),sarvanga(whole body), degenerative disease which can cause difficulty in good functioning and movement of the body, in progression leads to weakness, this disease is motor neuron disease. The Ayurveda way of approach is to bring dosha back to prakruta awastha (balance state) in guna (quality),sthana (place), and karma (function), and help rehabilitate the affected part by Ayurvedic panchakarma treatment.