Onset and spreading patterns of upper and lower motor neuron symptoms in amyotrophic lateral sclerosis.

The article presents a study which analyzed the extent of upper motor neuron (UMN) and lower motor neuron (LMN) involvement during disease onset and disease progression in the amyotrophic lateral sclerosis (ALS) outpatient patient clinic database. Patients having atypical ALS features were not included in the analysis. Percentages of patients with bulbar or spinal onset were equal at first time-point and at 1-year follow-up time-point. In all onset regions at the first visit, LMN involvement was more classifiable than the UMN involvement.