Hi. My name's Gary.

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Gary
Arrow pointing Gary

You’re more likely to
meet someone with
MND than a Gary

Unlike the name Gary, motor neurone disease (MND) is
more common than you might think. A person’s lifetime
risk of developing MND is around 1 in 300.

Rapid and accurate diagnosis is crucial to ensure the
needs of patients with MND are met from the earliest
possible stage.

Scroll through or click the hotspots on Gary, below, to
see which symptoms to look out for, how they may feel
to patients, and when to refer to a neurologist.

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Gary
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If your patient has one or
more of these symptoms
and there’s progression,
refer them to a neurologist.


Know the signs and
know when to refer.

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Download or Share pointer Download the
Red Flag Tool
here.

Bulbar features

25% of patients present with bulbar symptoms.

Download or Share pointer Download the Red Flag Tool here.
Gary Bulbar

Dysarthria

Slurred or quiet speech
often when tired

“I am finding that I sometimes
slur my words – other people
are noticing it too.”

Tongue
fasciculations

“My tongue occasionally
twitches and ‘flickers’.”

Swallowing
difficulties – Dysphagia

  • Liquids and/or solids

“Difficulty swallowing liquids and/or solids.”

  • Excessive saliva

“Producing excessive saliva or build up
because can’t swallow it.”

  • Choking sensation especially
    when lying flat

“I have difficulty swallowing – it
feels like I can’t get my food to go
down, almost a choking sensation.”

Limb features

70% of patients present with limb symptoms.

Download or Share pointer Download the Red Flag Tool here.
Gary Limb

Focal
weakness

“I’m not in pain but don’t have
the strength I used to when
doing everyday things –
carrying shopping, undoing
jars that kind of thing.”

Loss of
dexterity

“It’s as if I can’t control my
fingers. I’m having difficulty
with simple things –
unscrewing the petrol cap,
doing up zips and buttons.”

Cramps

“I get cramps in my leg.”

Foot drop

“My foot and leg feel heavy
and seem to ‘drag’ when I
walk – sometimes I fall over
because of it.”

Respiratory features

Respiratory problems are often a late feature
of MND and an unusual presenting feature.
Patients present with features of
neuromuscular respiratory failure.

Download or Share pointer Download the Red Flag Tool here.
Gary Limb

Early morning
headache

“When I wake up I am still tired
and I feel a bit hungover, my
head is ‘muzzy’.”

Shortness of
breath on
exertion

“I get quite breathless – for
example if I walk fast or run
for the bus or train.”

Excessive
daytime
sleepiness/
fatigue

“I feel tired during the day – I’ve not
felt like that before. I don’t seem to
have any energy.”

Orthopnoea

“When I go to bed and lay
down I find it harder to breathe
– it’s better when I sit upright.”

Cognitive features

Frank dementia at presentation is rare.

Download or Share pointer Download the Red Flag Tool here.
Gary Limb

Emotional
lability

“I find myself crying for no
real reason sometimes.”