Websites on motor neurone disease

Websites related to this week's Clinical Review selected by Dr Keith Barnard.

AMYOTROPHIC LATERAL SCLEROSIS

They are fond of calling this Lou Gehrig's disease in the US, but I suppose we can't complain seeing as this excellent account of this most common variant of motor neurone disease comes from across the pond. This well-referenced and sympathetic account of the condition is detailed, but aimed at the family practitioner.

The table of diagnostic criteria helps clarify what is often a difficult initial diagnosis, and the clinical features are well documented here.

The emphasis is on the fact that this is usually a clinical diagnosis based on history and physical examination, bringing the GP's skills to the fore.

Why go there: all you need to know.
Downside: no images.
Information from: American Academy of Family Physicians.
Address: www.aafp.org/afp/990315ap/1489.html

FOCAL MUSCULAR ATROPHIES

When you see how much there is on these pages you might wonder why I've suggested a visit. But don't panic, all I'm suggesting is that you skim through the history, physical signs and causes sections. And then whiz right through to almost to the end where there are a couple of interesting clinical images that are worth a look. The rest, well, trust me, you really don't need to read it.

Why go there: for some selective reading.
Downside: very wordy.
Information: e-Medicine.
Address: www.emedicine.com/neuro/topic137.htm

GENETIC RESEARCH

In 90 per cent of cases of motor neurone disease, there is no evidence that it is inherited, and this is called sporadic disease.

Familial disease is said to occur in those 10 per cent where there is a history of the disease in close family members. These pages describe how a UK research facility is trying to track down genes associated with this form of the disease.

One such programme looks at one glue mutation or an altered gene called SOD1 that has been identified as the direct cause of familial MND. However, only 20 per cent of those affected have been shown to have this mutation.

It is possibly the one way forward that might eventually lead to an effective treatment.

If you know of an affected family, they might be able to help the research project.

Why go there: interesting.
Downside: complicated.
Information from: King's College, London.
Address: www.mndcentre.org.uk/Research/GeneticFront.html

- Dr Barnard is a former GP in Fareham, Hampshire

- Clinical Review, page 47

WEBSITE OF THE WEEK

This is a refreshing change from some of those charity sites that so often seem to make unwise investments in web design.

These pages are clean and easy to read, and although they have tried to put too much on the homepage, navigation is simple enough.

There is a special section for medical professionals, and that is what makes the site so useful to GPs. Although not a common condition, any GP who has cared for a patient dying of this distressing disease will know how essential expert support for the patient and the doctor can be.

The Motor Neurone Disease Association provides a range of such services, and will even give advice on individual cases.

Much of the site is aimed at sufferers, and there is a special section for those who have been newly diagnosed. The whole tone of the site is supportive, and that is just what these unfortunate patients need.

I highly recommend this site.

Why go there: good, well-presented information for patients and GPs.
Downside: none.
Information from: Motor Neurone Disease Association.
Address: http://www.mndassociation.org/

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