major role
motor neuron cell bodies under pyramidal located cranial motor nucleus and anterior horn cell movement, which projections are composed of cranial and spinal nerves, dominated the whole body bone voluntary movement of muscles. When the lower motor neuron damage due to loss of muscle innervation, decreased muscle tone, flaccid paralysis; muscle atrophy due to nutritional disorders; reflex arc because all are interrupted, shallow, deep reflection disappeared; no pathological reflexes.
injury authentication
1 and lower motor neurons flaccid paraplegia: paraplegia due to motor neuron disease in the flaccid characterized by varying degrees of paralysis, it may be incomplete or complete. Complete flaccid paraplegia sides equal degree of paralysis. Muscle atrophy associated vasomotor disorders, such as floating suction, skin bruising, as well as skin dystrophy, when the current root irritation lesions, may have muscle fibrillation. Tendon reflexes reduced or even disappear, especially Achilles tendon reflex, no pyramidal signs, no Babinski sign, while sphincter disorders. If you have incontinence, or as a result of the bladder muscle paralysis, it was neurogenic bladder, urinary incontinence showed persistent cauda equina nerve damage. .
2 motoneurons spastic paraplegia on: the performance of both legs complete paralysis, deep hyperreflexia; light reflection (e.g., abdominal reflex, cremasteric reflection) reduced or lost; pathology may occur reflector (e.g., Babinski sign); for the normal motor neurons, muscle atrophy does not occur early in the course.
Symptoms
First, patients are usually common to small hand muscle weakness and muscle atrophy gradually onset, may affect one or both, or from one side to start later spread to the contralateral side. Meanwhile muscular atrophy of extending upward, gradually violation of the forearm, upper arm and shoulder strap. Muscle weakness, reduced muscle tone, tendon reflexes diminished or disappeared. Fasciculation common, may be limited to certain muscles or widespread, hand flapping, easily induced current.
Second, hoarseness, tongue muscle atrophy, speech is unclear, difficulty swallowing, saliva outflow, eating or drinking cough, dyspnea, sputum difficult to expectorate.
Third, for the upper motor neuron mainly for patients with limb weakness, tight, moves failed. Experts point out that, due to the disease often first invaded and lower thoracic spinal cord of the corticospinal tract, so the symptoms start with lower limbs begin later spread to upper limbs and lower limbs as the most important. Therefore, patients with these symptoms should be alert to the movement of motor neuron disease. Further, for the type of motor neuron patients than 30 years after the onset.
Fourth, unilateral or bilateral hand weakness, and with a clear fibrillation, the size of the thenar muscle atrophy.
five, upper limb muscles and scapular muscle atrophy, difficulties raising his hand, hair weakness, paralysis of lower limbs were spastic, slow walking gait scissor shape.
diagnostics
1 start of symptoms: early morbidity, may not be the hand grip chopsticks, or walking will fall for no reason; some started by hoarseness, without any obvious symptoms. This time to be a neuromuscular physician for EMG, nerve conduction velocity, MRI and other necessary checks to confirm the diagnosis. .
2 work difficult period: limb weakness has been evident, even atrophy, life can still take care of themselves, but already the workplace obstacles. At this point need appropriate rest, so as not to aggravate their condition. By physiatrist assessment, to provide the necessary rehabilitation and psychological adjustment assistance and social resources by the social workers.
3 life difficult period: the medium-term course of the disease into the hands or feet, or hands and feet at the same time has been a serious obstacle, life can not take care of themselves, may be unable to walk, dress, holding chopsticks, and slurred speech. .
4 of dysphagia: Go to the end of the limbs almost completely unable to speak a serious obstacle, easily choked while eating, some need tube feeding feeding, otherwise easily lead to aspiration pneumonia.
5 breathing difficult period: the respiratory muscles are affected, difficulty breathing, bedridden patients may need to use a respirator, some patients will choose to live in respiratory therapy centers or home care, while others accept the peace team service.
prevention
First, normal life, we should pay more attention to regulate their mood, to feel pleasure.
Second, during the illness, appropriate exercise to maintain good, insist on doing simple tasks. However, to avoid strenuous activities, so as not to aggravate their condition.
Third, always pay attention to oral hygiene, to remove food residues retained.
Fourth, we must pay attention to diet, eat more nutritious foods, eat more protein and vitamins.