Motor neurone disease: prompt referrals needed to expedite diagnosis

MND NZ research advisor and best practice advocate Dr Natalie Gauld discusses the hallmarks of MND and the need for prompt neurology review if MND is suspected.

With a lifetime risk of 1 in 300 to 1 in 400, doctors and other healthcare professionals need to be alert to the possibility of MND and refer promptly. MND is insidious and has a wide range of presentations, so diagnosis can be delayed.

The hallmark is progressive and painless muscular weakness without sensory disturbance. See the panel for common first symptoms.

If MND is suspected, refer promptly for neurology review. Include the possible diagnosis in the referral letter. Contact the consultant neurologist directly if an urgent consultation is needed e.g. respiratory compromise, rapid weight loss, rapid loss of function, unable to manage activities of daily living.

Advise the patient to return if they worsen while waiting for a neurology appointment and contact the consultant neurologist if the situation has become urgent.

Motor Neurone Disease New Zealand launched Best Practice Recommendations in 2023, providing comprehensive information about signs and symptoms and management of MND. Multi-disciplinary support provided early is important to help manage this disease.

MND NZ has support advisors throughout New Zealand to support patients and whānau through the MND journey.

Given this is MND action month, we want to remind doctors to consider MND as a possible diagnosis and refer promptly if suspected.