JOHANNESBURG – Many have questioned whether there is a link between rugby-linked head injuries and Motor Neuron Disease (MND) in light of cases including Joost van der Westhuizen, Tinus Linee, John Mudgeway, Ryan Walker and Jarrod Cunningham, all professional rugby players that have all suffered from the disease.
Speaking to Radio 702’s Redi Tlhabi, Dr David Anderson, a Neurologist at the Wits Donald Gordon Medical Centre, explains although the disease is associated with recurrent head injury, the actual cause has not been found.
The most common form of MND is amyotrophic lateral sclerosis (ALS) which affects both upper and lower motor neurons.
“There’s an increased risk with head injury. Studies have shown that with repeated head injury it increases your risk of getting ALS.”
He said studies have shown there’s a double risk with repeated head injury.
“In Italy, soccer players who had recurrent head injuries with loss of consciousness had about a six-fold increased risk.”
Is it genetics?
It is. Between five and 10 percent of MND is genetic and in those cases often associated with dementia. The gene was discovered 20 years ago, and is a small percentage and its more people with European descent. But the majority are sporadic without any obvious cause found.
What happens when one suffers from Motor Neuron Disease?
In the majority of cases, it starts with weakness. It can start slowly and anywhere in the body. In some cases it can start with a speech problem or a swallowing problem. It’s usually very subtle and not noticed right away but eventually progresses.
It can sometimes be misdiagnosed as a small stroke or an injured nerve but the hallmark of it is there is no sensory problem, it’s purely a weakness syndrome which progresses relatively rapidly, which differentiates it from a stroke. A stroke is a sudden problem which gets better whereas Motor Neurone Disease progresses.
Once you’ve been diagnosed, what can you do?
It’s the worst diagnosis a doctor can give. We follow very strict criteria, we look for every other possible diagnosis, and we hunt for everything else. Unfortunately there isn’t one test that gives the absolute diagnosis, so we look for very specific criteria.
You have to have all the right signs and all the right places before we give the diagnosis.
Once we give the diagnosis, there is no treatment that really helps. There is one drug that may add a few months onto their life but ultimately, all patients die from it.
People are often in their prime when they are preparing to enjoy what they have created. They lose their independence and have to depend on other people because they are completely unable to move.
The other thing about repeated head injuries is that you can also damage the brain and it can be associated with dementia in its own right, not just Motor Neuron Disease.
What studies are being done to find a cure?
There is a lot being done on all fronts of neuro-degenerative diseases. The problem is, we don’t have the cause. Until we know what the cause is, finding a cure makes it very difficult.
Until we’d found the HIV virus in the 80s, the treatment couldn’t follow. Until we find the actual cause, I don’t think we’ll find a cure.
There are trials going on especially in ALS, two very exciting trials in the United States which are looking very encouraging at the moment.
