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Cover of Motor Neurone Disease

Motor Neurone Disease

The Use of Non-Invasive Ventilation in the Management of Motor Neurone Disease

NICE Clinical Guidelines, No. 105



Motor neurone disease (MND) is a fatal neurodegenerative disease. It is characterised by the onset of symptoms and signs of degeneration of primarily the upper and lower motor neurones. This leads to progressive weakness of the bulbar, limb, thoracic and abdominal muscles. Respiratory muscle weakness resulting in respiratory impairment is a major feature of MND, and is a strong predictor of quality of life and survival. Non-invasive ventilation can improve symptoms and signs related to respiratory impairment and hence survival.

There is currently no evidence-based guideline for use in England, Wales and Northern Ireland that addresses the use of non-invasive ventilation in patients with MND. This guideline considers the signs and symptoms that can be used for predicting respiratory impairment in patients with MND, the diagnostic accuracy of investigations for detecting and monitoring respiratory impairment, the clinical and cost effectiveness of non-invasive ventilation for treating respiratory impairment and the information and support needs of patients and their families and carers relating to the use of non-invasive ventilation.


NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales.

This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering.

Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Copyright © 2010, National Institute for Health and Clinical Excellence.

All rights reserved. This material may be freely reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the express written permission of NICE.

Bookshelf ID: NBK65383PMID: 22171400


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