MND Symptoms & Diagnosis

Motor neurone disease affects each person differently, and its early signs can be subtle and easy to mistake for something else. This page gives a clear overview of how it typically presents and how it is diagnosed. It is general information, not medical advice; anyone concerned about symptoms should speak to a doctor.

Early symptoms

MND is caused by the gradual loss of the nerve cells, the motor neurones, that control voluntary muscle movement. Because those nerves serve different parts of the body, the first symptoms vary. Common early signs include weakness in the hands or legs, a weakening grip, tripping or stumbling, muscle cramps and twitches, slurred or quieter speech, and difficulty swallowing. Often the changes start in one area, a hand, a foot, the voice, before spreading.

In Hawking's case, the first hints appeared during his early twenties: increasing clumsiness and a few unexplained falls, including a fall while skating. It was these seemingly minor problems that led, eventually, to his diagnosis at 21.

Why diagnosis is difficult

There is no single test that confirms MND. Because its early symptoms overlap with many other, often more treatable, conditions, doctors usually reach a diagnosis partly by ruling those other possibilities out, which takes time and can be a frustrating, anxious period for patients and families.

A neurologist will typically carry out a detailed clinical examination and may use tests such as electromyography (EMG) and nerve conduction studies, which measure the electrical activity of muscles and nerves, along with MRI scans and blood tests to exclude other causes. The picture is built up over weeks or months rather than from one moment.

After diagnosis

A diagnosis of MND is life-changing news, and the period around it is one of the hardest. Specialist MND care teams exist precisely to help people through it, and the support of organisations like the MND Association can make a real difference from the very start. For what comes next, see the pages on living with MND and research and treatment.

If you or someone close to you is affected by MND, the MND Association offers information and support. You can find ways to help on the support page.