TREATMENT of Dementia in Motor Neuron Disease

Medical Care

Direct prehospital care to aspects of MND that accompany the dementia.
Evaluate and treat sialorrhea, impaired breathing, swallowing, and mobility.
Consider neuroprotective agents (eg, riluzole, gabapentin) or nutritional supplements (eg, creatine) to preserve muscle bulk, but note that their efficacy in FTD/MND is even more uncertain than in MND.

Surgical Care

There is no surgical treatment for FTD/MND.
Consider gastrostomy tube feeding for patients with severe bulbar symptoms, severe dysphagia, and relatively mild dementia and limb weakness.

Diet

Patients may develop bulbar palsy, necessitating parenteral nutrition or percutaneous gastrostomy. Prior to gastrostomy, mechanically soft diets can be tried.

Activity

Level of activity is dictated by progression of MND.