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Upper vs Lower Motor Neuron Diseases

Upper vs Lower Motor Neuron Diseases

When we receive a Motor Neuron Diagnosis (MND) diagnosis, our first worry is about the extent to which our life is going to change because of the neurodegenerative disorder. Muscle weakness can leave us feeling extremely tired, physically invalid, and even emotionally disturbed. Not being able to perform simple everyday tasks can take a heavy toll on the individual’s mental health.

But, the first step to living with MND is to understand the course of treatment that will work best. And to receive the best treatment for MND one has to know the type of MND they have.

In this article, we will help you understand the difference between upper motor neuron diseases and lower motor neuron diseases.

What is MND?

MND is a group of neurodegenerative disorders that selectively affects motor neurons, the cells which control all the voluntary muscles of the body. Voluntary muscles are responsible for performing movements under one’s will.

Treatment for MND includes Stem Cell Therapy, Physiotherapy, Occupational Therapy, and Speech Therapy.

What are upper motor neurons and lower motor neurons?

There are two kinds of neurons in the body – the upper motor neurons in the brain, and the lower motor neurons in the spinal cord. 

The upper motor neurons transmit messages to the spinal cord from the brain.

The lower motor neurons transmit messages from the spinal cord to the muscles.

Essentially, the motor neurons control voluntary  movements in different parts of the body.

Motor neuron diseases (MND) are classified as upper MND and lower MND based on which neurons have been affected. 

Difference between Upper MND and Lower MND

Upper motor neurons originate in the cerebral cortex and descend through the spinal cord. Here they interact with the lower motor neurons.

The symptoms of upper MND are:

  • Hyperactive reflexes
  • Increased muscle tone
  • Weakness (without serious atrophy)
  • Rigidity
  • Spasticity
  • Tremor
  • Minimal paralysis of voluntary muscles
  • Dystonia (repeated and/or involuntary twisting movements)
  • Involuntary contractions of the extremeties 
  • Irregular movements in the distal extremities

Lower motor neurons are in the central and peripheral nervous systems. They control the skeletal muscles of the body. Below are the symptoms of lower MND:

  • Atrophy
  • Flaccidity
  • Muscle twitching
  • Ipsilateral weakness of individual muscles
  • Loss of muscle tone
  • Weak or absent deep tendon plantar and abdominal reflexes

Bell’s Palsy is the most common type of lower MND. Amyotrophic Lateral Sclerosis (ALS), Primary Lateral Sclerosis (PLS) and Multiple Sclerosis (MS) are a combination of upper and lower MND.

What are motor lesions?

An upper motor neuron lesion is the inflammation of/along the neural pathway. The lesions are above the motor nuclei of the cranial nerves or the anterior horn of the spinal cord.

Upper motor neuron lesions result in spastic hyperreflexia and muscle weakness. 

Lower motor neuron lesions affect nerve fibers traveling from the anterior horn (of the spinal cord) and relaying messages to the muscles. Lower motor neuron lesions are typically caused by

  • Spinal cord injury with nerve root compression
  • Poliomyelitis
  • Peripheral neuropathy
  • And even MND

MND diagnosis

An MND diagnosis is critical because its symptoms may be typical of other neurological diseases too. However, an MND diagnosis in the initial stages may be difficult. In order to arrive at a proper diagnosis, the neurologist may ask for the following tests:

  • Electromyography (EMG) to measure electrical activity of muscle in response to stimuli
  • MRI of brain and spine
  • Lumbar puncture to assess the spinal fluid
  • Blood tests

Plexus MND Rehabilitation

India’s first ISO certified stem cell research center, Plexus offers stem cell therapy that has greatly benefited patients with MND. Stem cells can slow down the rate of neurodegeneration and also have the capacity to self-renew, regenerate the cell, and repair damaged tissue. 

Choosing Plexus for your treatment ensures you are treated by India’s foremost neurologist and stem cell specialists, Dr Na’eem Sadiq. Along with his team of dedicated, compassionate, and highly-experienced stem cell specialists, Dr Sadiq brings you the best treatment for MND in the form of regenerative rehabilitation. This includes:

  • Endurance training and fatigue management
  • Strengthening of shoulder muscles, upper and lower limbs, oral structures
  • Functional stretching to relieve rigidity and stiffness
  • Dysphagia management
  • Activities of Daily Living training (ADL)
  • Energy conservation and work simplification training
  • Functional splinting
  • Hand function training
  • Counseling and caregiver education


Book an appointment with us today.

Call +91 89048 42087 | 080-2546 0886

080-2547 0886 | 080-2549 0886


Is stroke a lower MND or upper MND?

Stroke is an upper motor neuron disease.

Is Parkinson’s a lower MND or upper MND?

Not Parkinson’s, but Parkinsonian syndrome can occur in MND. The symptoms are typically observed in patients with ALS and PLS.

Is Bell’s Palsy a lower MND or upper MND?

Bell’s Palsy is the most common type of lower MND.

Is flaccid paralysis an upper MND or lower MND?

Flaccid paralysis is a result of LMN lesions.

What are the four characteristics of upper motor neuron lesions?

Hyperreflexia, spasticity, muscle weakness, and motor clumsiness are the most common characteristics of upper motor neuron lesions.

What are the signs of lower MND?

The signs of lower MND are:

  • Atrophy
  • Flaccidity
  • Muscle twitching
  • Ipsilateral weakness of individual muscles
  • Loss of muscle tone
  • Weak or absent deep tendon plantar and abdominal reflexes
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