New hope for patients with pure lower motor neuron syndromes

Motor neuron disease is still one of the most dramatic neurological conditions; it reflects a range of which one end encompasses patients with the bulbar form of amyotrophic lateral sclerosis who have dysarthria and dysphagia and have a dramatically shortened life expectancy. For patients with probable or definite motor neuron disease according to established criteria, the recent introduction of the antiglutamate drug riluzole gives a mean prolongation of life after diagnosis of some 3 months.1 The other end of the range of motor neuron disease is formed by patients with so called multifocal motor neuropathy. This is characterised by lower motor neuron dysfunction in the areas of selected motor nerves. Neurophysiological demonstration of conduction block over these nerves is pivotal for the diagnosis.2 Before the discovery of multifocal motor neuropathy as a separate and treatable condition, patients with …