PT  - JOURNAL ARTICLE
AU  - Martin R Turner
AU  - Kevin Talbot
TI  - Mimics and chameleons in motor neurone disease
AID  - 10.1136/practneurol-2013-000557
DP  - 2013 Jun 01
TA  - Practical Neurology
PG  - 153--164
VI  - 13
IP  - 3
4099  - http://pn.bmj.com/content/13/3/153.short
4100  - http://pn.bmj.com/content/13/3/153.full
SO  - Pract Neurol2013 Jun 01; 13
AB  - The progression of motor neurone disease (MND) is currently irreversible, and the grave implications of diagnosis naturally fuels concern among neurologists over missing a potential mimic disorder. There is no diagnostic test for MND but in reality there are few plausible mimics in routine clinical practice. In the presence of a progressive pure motor disorder, signs such as florid fasciculations, bilateral tongue wasting, the ‘split hand’, head drop, emotionality, and cognitive or behavioural impairment carry high positive predictive value. MND is clinically heterogeneous, however, with some important chameleon-like presentations and considerable variation in clinical course. Lack of confidence about the scope of such variation, or an approach to diagnosis emphasising investigations over clinical common sense, has the potential to exacerbate diagnostic delay in MND and impede timely planning of the care which is essential to maximising quality of life.