**5. Clinical presentation of motor neurone disease**

Dilemmas of symptoms and signs are described for diagnosis of MND and its subtypes. Motor symptoms of both upper and lower motor neuron dysfunction can occur in any muscle group, including limbs, and, or bulbar regions. Combinations of the previous motor symptoms is not characteristic for MND and can be observed in many diseases, known as "MND Mimic Disorders" such as, Kennedy's diseases, multifocal motor neuropathy, brainstem lesions (syrinx, stroke,………. etc)

Meticulous evaluation by thorough history and examination by two or more specialists of neurology are required for diagnosis of MND. Special investigations are required for diagnosis of MND and differentiation from MND mimics.


Table 1. Stages of Motor Neuron Disease (MND)
