There is no cure for Motor neurone Disease. Riluzole is available for patients with Amytophic Lateral Sclerosis but not for people with any of the other types of MND.
Riluzole works by inhibiting the release of glutamate, decreasing the firing of motor neurone induced by glutamate receptor agonists, thus protecting cells from glutamate mediated damage. Riluzole does not stop the disease process but is felt to be effective in slowing it down, particularly in the early stages. The NICE guidance on Riluzole states that the main caution for the use of riluzole is a history of abnormal heptatic function- it therefore recommends regular blood testing (every month for three months, every three months for a further nine months and annuallly thereafter).
The effect of taking riluzole is described as modest, prolonging life by 3-4 months on average.
Side effects with riluzole can include nausea, vomiting, weakness, tachychardia, somnolence, headache, dizziness, vertigo, pain, parasthesia and alterations in liver function tests. Dizziness or vertigo may prevent the performance of skilled tasks such as driving. Riluzole should not be given to patients with hepatic and/or renal impairment and during pregnancy and breast feeding.
Another recent development has been that discovery of the beneficial effects of non-invasive ventilation which ihnvolves the patient using a mask ventilator system overnight during sleep. Patients use small and portable machines and can choose from a vareity of different masks. A randomised trial found that the use of such ventilation increased life expectancy by about seven months- this was accompanied by an improvement in multiple quality of life measures. The BMJ comments that "this effect on survival is much greater than that currently provided by neuroprotective treatments such as riluzole".
In the absence of an effective cure, much of the treatment available for MND focuses on help with managing the symptoms of the disease. Someone with MND may benefit from the attentions of a speech therapist, a physiotherapist, a dietician, an occupational therapist etc all of whom will be able to provide valuable advice and support.
Complementary Therapies
The Motor neurone Disease Association says that following therapies can improve the quality of life of many people with MND:
The Association advises people with MND to discuss any proposed course with their gp before embarking on any form of complementary treatment.
