London Neurologist

Motor Neurone Disease Specialist

Professor Michael Hanna is dedicated to delivering exceptional guidance and compassionate care to patients and their families. With his profound understanding of the complexities of MND, Professor Michael Hanna offers the best possible advice and comprehensive support throughout your journey.

Understanding Motor Neurone Disease

Motor Neurone Disease (MND) is a neurological condition that progressively weakens the muscles over time. It is caused by degeneration of motor neurons which are located in the brain and in the spinal cord. When the motor nerurone degenerate there is an interruption in the electrical signals motor neurons send to muscles.

This leads to muscle weakness, stiffness, and wasting, affecting crucial functions like eating, walking, talking, and breathing.

However, the progression and manifestation of symptoms can vary greatly from person to person, making it challenging to predict the course of the disease.

How common is Motor Neurone Disease?

Motor Neurone Disease (MND) is a relatively rare condition, affecting approximately 5,000 individuals in the UK at any given time. The risk of developing MND stands at 1 in 300 people during their lifetime.

While it is more commonly observed in individuals over the age of 50, MND can develop at any age. Due to its low prevalence, healthcare professionals may have limited experience in working with MND patients, necessitating effective measures for diagnosis and treatment.

Understanding symptoms of Motor Neurone Disease (MND)

This complex condition can impact individuals in unique ways, resulting in a diverse range of symptoms. Here are some of the common symptoms associated with MND:

  • Muscle weakness: MND can cause a loss of muscle mass and mobility problems, leading to difficulties in everyday tasks.
  • Muscle cramps and spasms: Individuals with MND may experience muscle twitching, known as fasciculation, which can be uncomfortable.
  • Stiff joints: MND can limit the range of movement in joints, making tasks such as walking and reaching more challenging.
  • Pain or discomfort: MND symptoms can result in pain or discomfort, often arising from other associated symptoms.
  • Speech and communication problems: Changes in speech patterns, gestures, and emotional expressions can occur due to the impact of MND on the muscles involved in these functions.
  • Difficulties swallowing and Saliva problems: MND can lead to difficulties in swallowing, and individuals may experience problems with saliva, such as pooling in the mouth or thickening.
  • A weaker cough: MND can affect the strength of the cough reflex, making it harder to clear the throat effectively.
  • Breathing problems: MND may lead to breathlessness and fatigue due to the weakening of the respiratory muscles.
  • Changes in behavior and thinking: Inappropriate emotional responses and alterations in behavior and thinking can be observed in individuals with MND.


Diagnosing MND in its early stages can be challenging given the lack of a single diagnostic tool and the presence of several other conditions that present similar symptoms. Therefore, to ensure an accurate diagnosis and differentiate MND from other potential disorders that may mimic its symptoms, an extensive and thorough neurological assessment becomes essential.

To assist in the diagnosis and to rule out similar conditions, Professor Hanna may recommend some or all of the following diagnostic tests:

  • Blood test: This test can help to evaluate potential underlying conditions that may present similar symptoms to MND.
  • Scan of brain and spine: An MRI or CT scan can provide a detailed image of the brain and spine allowing for the identification of any abnormalities.
  • Electromyography (EMG): This is a diagnostic test that measures the electrical and muscle activities in the muscles and nerves, helping to assess the functionality of motor neurons and detect any abnormalities that may indicate MND.
  • Lumbar puncture (spinal tap): In some cases, a lumbar puncture may be recommended to collect cerebrospinal fluid for analysis to detect MND.

Motor Neuron Disease Treatment Options

Although a cure for Motor Neurone Disease (MND) has yet to be discovered, there are several treatment options available that can significantly alleviate symptoms and enhance the quality of life for individuals affected by the condition.

Here are some examples of the treatment options he provides:

  • Feeding support: In cases where swallowing difficulties arise, Professor Hanna may recommend feeding support, such as a gastrostomy. This intervention ensures proper nutrition and hydration, preventing complications related to inadequate food intake.
  • Breathing and ventilation support: As MND progresses, breathing difficulties may arise. Professor Hanna offers various strategies and interventions to support respiratory function, including the use of non-invasive ventilation techniques, which can significantly improve breathing and reduce the risk of complications.
  • Riluzole: Riluzole is a medication that has shown a small effect in slowing down the progression of MND. Professor Hanna can discuss the potential benefits and risks of this medication and help patients make informed decisions about incorporating it into their treatment plan.
  • Medications for symptom management: MND can cause muscle stiffness and difficulty with saliva control. Professor Hanna may prescribe medications that specifically target these symptoms, providing relief and improving comfort.
  • Physiotherapy: Physiotherapy is an integral part of MND treatment. Professor Hanna can connect patients with experienced physiotherapists who specialise in working with individuals with neurological conditions. Through tailored exercise programs, physiotherapy can help improve mobility, maintain muscle strength, and enhance overall physical function.
  • Speech and language therapy: Communication difficulties often arise as MND progresses. Speech and language therapy, recommended by Professor Hanna, can help individuals maintain their ability to communicate effectively, utilising techniques such as alternative communication methods and swallowing exercises.
  • Special equipment and mobility aids: To enhance independence and improve daily living, Professor Hanna may recommend the use of special equipment and mobility aids. These assistive devices can help individuals navigate their environment more easily and maintain their autonomy for longer.

Appointments and more information

Professor Hanna is an internationally recognised expert in muscle wasting neurological conditions and has published over 400 research articles on neurological subjects including neuromuscular diseases, mitochondrial diseases, channelopathies, inclusion body myositis, myasthenia gravis and motor neurone disease.

If you are concerned about your symptoms and would like to arrange a neurological assessment, or wish to discuss your mitochondrial disease diagnosis and treatment, please make an appointment. Professor Hanna is available for private or NHS appointments.

NHS Appointments

A letter of referral is required from your GP or NHS Practitioner. Referrals should be sent to my NHS Office.

NHS Office Address:
Centre for Neuromuscular Diseases
The National Hospital for Neurology and Neurosurgery
Queen Square
NHS Office Enquiries
Tel: 020 3448 8014/8251
Fax: 020 3448 3633

Private Appointments:

A letter of referral may be required for private patients who have Private Medical Insurance (PMI). Self-paying patients can self-refer.

Private Office Address:
The Private Consulting Rooms
The National Hospital for Neurology and Neurosurgery
Queen Square
Private Office Appointments and Enquiries
Tel: 020 3448 8935
Fax: 020 3448 8816

Please view the Terms & Conditions for more information.