IMPORTANT: For use by qualified healthcare professionals only
IMPORTANT: For use by qualified healthcare professionals only. Always seek advice from a qualified clinician before any medical or prescribing decision. MND Clinical Guide is a comprehensive, evidence-based clinical reference for the assessment and management of motor neurone disease — built for neurologists, respiratory physicians, palliative care specialists, and all clinicians caring for people living with MND. DIAGNOSIS & CLASSIFICATION • MND subtypes: ALS, PLS, PMA, PBP, flail arm, flail leg — UMN/LMN involvement, features, prognosis • Gold Coast Criteria 2020 and El Escorial/Awaji criteria explained • ALS-FTD overlap: C9orf72, ECAS screening, capacity implications • Differentials: cervical myelopathy, Kennedy disease, MMN, CIDP, myasthenia gravis, IBM, SMA • Investigations: EMG/NCS, MRI, anti-GM1, genetic panel, respiratory function • ALSFRS-R scale and prognostic factors table DRUG TREATMENT • Riluzole: dosing, food interaction, monitoring protocol, LFT/FBC schedules, stop criteria • Edaravone (Radicava): MCI-186 trial, eligibility, UK named-patient access • Tofersen (Qalsody): FDA-approved 2023 for SOD1-ALS, VALOR & ATLAS trials, pre-symptomatic treatment — why ALL ALS patients should now be SOD1 tested • AMX0035 (Relyvrio): CENTAUR trial, PHOENIX failure, withdrawal September 2024 • Active trials: ION363, C9-ASO, TUDCA, TRICALS SYMPTOM MANAGEMENT • Spasticity: baclofen titration, abrupt cessation warning, respiratory caution • Sialorrhoea: glycopyrronium, amitriptyline, botulinum toxin, salivary irradiation • Pseudobulbar affect, cramps, pain, thick secretions, insomnia, anxiety, depression • Anticipatory medications: morphine, midazolam, glycopyrronium, levomepromazine SC RESPIRATORY MANAGEMENT • FVC sitting/supine, SNIP, PCF, MIP, overnight oximetry — values and NIV thresholds • NIV criteria (NICE NG42). • BiPAP settings, mask selection, bulbar disease considerations • Tracheostomy: UK vs international practice, ethical and withdrawal considerations • Acute failure algorithm — avoid high-flow oxygen alone in MND NUTRITION & DYSPHAGIA • SALT referral, videofluoroscopy, FEES, IDDSI texture levels 0–7 • PEG vs RIG by FVC • Targets: 35–45 kcal/kg/day, protein 1.2–1.5g/kg/day, LIPCAL-ALS high-fat evidence COMMUNICATION & AAC • 4-stage communication decline with interventions at each stage • Voice banking: ModelTalker, VocaliD, ACAT/Acapela — start at diagnosis • AAC: Tobii Dynavox, Grid Pad, iPad Grid 3, eye gaze, BCI referral guidance GENETICS & BIOMARKERS • C9orf72, SOD1, FUS, TDP-43, UBQLN2 — clinical implications for each • TDP-43: pathological hallmark of 97% of all ALS • 6-step genetic testing protocol, NfL as emerging biomarker • UK Concordat on Genetic Testing and Insurance MDT & PALLIATIVE CARE • 10-member MDT roles table with referral timing • Advance care planning: NIV, gastrostomy, DNACPR, LPA, emergency healthcare plan • End of life: morphine for dyspnoea, NIV withdrawal, anticipatory prescribing • Carer support: MND Connect 0808 802 6262, CHC, PIP, MNDA grants APP FEATURES • 37-entry clinical search — tap to navigate instantly • 10-question expert quiz with detailed explanations • My Notes — session-based personal clinical notes • A− / A+ font scaling for ward and clinic use • 20+ tappable references: NICE NG42, Gold Coast 2020, VALOR, ATLAS, CENTAUR, MCI-186, SOS-ALS, Bourke NIV DISCLAIMER This app is intended for use by qualified healthcare professionals only as a clinical decision-support and educational reference tool. It does not replace individual clinical assessment, local multidisciplinary team protocols or official prescribing information. Always consult the current NICE NG42 and MNDA guidelines before clinical decisions.
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| 1 | Item | ¥ 68 | CNY | 中国 |
