Ann Rehabil Med.  2017 Apr;41(2):328-331. 10.5535/arm.2017.41.2.328.

Motor Neuron Disease Presenting With Acute Respiratory Failure: A Case Study

Affiliations
  • 1Department of Rehabilitation Medicine, Gangnam Severance Hospital, Seoul, Korea. elope86@yuhs.ac
  • 2Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Rehabilitation Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

Abstract

Motor neuron diseases (MNDs) refer to a heterogeneous group of progressive neurologic disorders caused by degeneration of motor neurons. The diseases affect either the upper motor neurons, lower motor neurons, or both, and are characterized by weakness, atrophy, fasciculation, spasticity, and respiratory failure. We report a case of a 61-year-old male patient with no past history of cardiovascular or pulmonary disease, who presented with only dyspnea, and no indication of any other symptom such as muscle weakness, atrophy, or bulbar dysfunction. Neuromuscular conduction study, including a study of the phrenic nerve, confirmed the diagnosis of MND. The patient greatly improved giving respiratory assistance at night, using a noninvasive ventilator. This case indicates that MNDs should be considered as differential diagnoses for patients showing acute respiratory failure of unknown causes. This report will aid in the prompt diagnosis and treatment of MNDs.

Keyword

Motor neuron disease; Respiratory insufficiency; Mechanical ventilation

MeSH Terms

Atrophy
Diagnosis
Diagnosis, Differential
Dyspnea
Fasciculation
Humans
Lung Diseases
Male
Middle Aged
Motor Neuron Disease*
Motor Neurons*
Muscle Spasticity
Muscle Weakness
Nervous System Diseases
Phrenic Nerve
Respiration, Artificial
Respiratory Insufficiency*
Ventilators, Mechanical

Reference

1. Francis K, Bach JR, DeLisa JA. Evaluation and rehabilitation of patients with adult motor neuron disease. Arch Phys Med Rehabil. 1999; 80:951–963. PMID: 10453774.
Article
2. Norris F, Shepherd R, Denys E, U K, Mukai E, Elias L, et al. Onset, natural history and outcome in idiopathic adult motor neuron disease. J Neurol Sci. 1993; 118:48–55. PMID: 8229050.
Article
3. Similowski T, Attali V, Bensimon G, Salachas F, Mehiri S, Arnulf I, et al. Diaphragmatic dysfunction and dyspnoea in amyotrophic lateral sclerosis. Eur Respir J. 2000; 15:332–337. PMID: 10706501.
Article
4. Czaplinski A, Strobel W, Gobbi C, Steck AJ, Fuhr P, Leppert D. Respiratory failure due to bilateral diaphragm palsy as an early manifestation of ALS. Med Sci Monit. 2003; 9:CS34–CS36. PMID: 12761460.
5. Chen R, Grand'Maison F, Strong MJ, Ramsay DA, Bolton CF. Motor neuron disease presenting as acute respiratory failure: a clinical and pathological study. J Neurol Neurosurg Psychiatry. 1996; 60:455–458. PMID: 8774419.
Article
6. Al-Shaikh B, Kinnear W, Higenbottam TW, Smith HS, Shneerson JM, Wilkinson I. Motor neurone disease presenting as respiratory failure. Br Med J (Clin Res Ed). 1986; 292:1325–1326.
Article
7. Shoesmith CL, Findlater K, Rowe A, Strong MJ. Prognosis of amyotrophic lateral sclerosis with respiratory onset. J Neurol Neurosurg Psychiatry. 2007; 78:629–631. PMID: 17088331.
Article
8. de Carvalho M, Matias T, Coelho F, Evangelista T, Pinto A, Luis ML. Motor neuron disease presenting with respiratory failure. J Neurol Sci. 1996; 139(Suppl):117–122.
Article
9. Park HS. A case of motor neuron disease presenting as dyspnea in the emergency department. Korean J Fam Med. 2012; 33:110–113. PMID: 22745895.
Article
Full Text Links
  • ARM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr