Q: 53 years old uncle has been diagnosed as a motor neuron disease (MND) patient. I want to know whether Riluzole is available in India and if yes, where? What is motor neuron disease?

A:Motor Neuron Diseases (MND) are a group of degenerative disorders affecting the nerve cells that generate and carry out movement via their action upon muscles. Therefore, weakness and other symptoms pertaining to muscular inactivity like wasting (thinning), twitching (fasciculations), stiffness (spasticity) etc. are the main features of these conditions. There are different types of motor neurons, hence there are different presentations of this disease. Not all forms are rapidly progressive, and not all types of motor neuron diseases cause early death. Some forms of this disease are restricted to certain muscle groups like hand or leg only. However, the most common presentation “Amyotrophic Lateral Sclerosis" is quite dangerous, affecting not only hands and legs, but face, muscles of speech and swallowing and also respiration, leading to early death. Motor neuron disease is a clinical diagnosis, which means there is no diagnostic test for its confirmation. Hence it is essential to exclude other potentially treatable conditions before confirming the diagnosis of this disease. For example, multilevel intervertebral disc disease, muscular wasting in patients who have had polio in childhood etc may mimic MND and should be ruled out. The only approved drug for MND is Riluzole. This is available in India, marketed by Sun pharma, and the company has graciously provided this costly medicine free of cost to patients of MND. You may want to contact the representative of this company in your city. Another drug Celecoxib is being evaluated as potential treatment for MND, but is still in the research phase.