Motor neuron disease (MND), called amyotrophic lateral sclerosis (ALS), is a neurodegenerative disease that occurs in middle-aged and elderly people between the ages of 40 and 70. According to the prevalence rate of 4-6/100,000 abroad, there should be 60,000 patients in China. The disease mainly affects the motor neuron system of the patient. Generally speaking, there are two major types of motor neurons in the body: upper motor neurons and lower motor neurons. Problems with upper motor neurons produce muscle stiffness and increased reflexes, which clinically manifest themselves in the form of jumping and uncoordinated walking. Because of the enhanced reflexes, sometimes the patient’s knees shake all the time, which are symptoms of upper motor neuron disease. As for lower motor neuron, the symptoms are mainly muscle atrophy, weakness and tremor. Usually the muscles between the palms and fingers are atrophied, and the tiger’s mouth is atrophied, slowly deteriorating to atrophy of the shoulders, neck, tongue, and swallowing muscles, causing difficulty in swallowing and respiratory failure. The cause of motor neuron disease is still unknown. 5% of cases may be related to genetic and genetic defects, and some environmental factors, such as heavy metal aluminum poisoning, may cause motor neuron disease. The main theories for the causes of motor neuron disease are (1) accumulation of neurotoxic substances, glutamate accumulates between nerve cells and over time, causing damage to nerve cells. (2) Abnormal mitochondrial energy metabolism and damage to nerve cell membranes. (3) Genetic mutations, of which SOD1,TDP43 and other genes have been clarified. 2, early symptoms Early motor neuron disease, dominated by weakness in the arms and legs or enhanced reflexes, is often mistaken for cervical nerve compression and undergoes cervical spine surgery. Only after the surgery, the situation does not progress and continues to deteriorate, is the diagnosis of motor neuron disease confirmed. Some patients whose symptoms are dominated by swallowing and breathing difficulties are also misdiagnosed as esophageal or neurological problems. In general, the early symptoms are not typical and easily confused with other diseases. 3.Early diagnosis To diagnose motor neuron disease early, in addition to neurological clinical examination, electromyography, nerve conduction velocity, serum specific antibody test, lumbar puncture cerebrospinal fluid examination, imaging examination, and even muscle biopsy are required. 4. Treatment (1) General and supportive therapy: symptomatic treatment and appropriate exercise. For example, pay attention to the function of the respiratory tract and digestive tract. If there is much saliva, amitriptyline 25 mg/night can be given; if there is much sputum, nebulized inhalation and phlegmolytic drugs such as Mucosolvan can be given; if there is depression, venlafaxine 75 mg antidepressant treatment can be given, etc. Turn more often to prevent bedsores. (2) Nutritional support: for eating disorders, give nasal feeding or PEG (percutaneous gastrostomy). (3) Special therapy: Many drugs, including herbal medicines, have been claimed to be effective for this disease, but none of them have been proven so far. At present, the only internationally recognized drug approved by the FDA for ALS treatment is Lerostil, and it must be used as early as possible. (4) Respiratory therapy: When breathing is not smooth at the beginning, general oxygen or BiBAP (double positive pressure respirator) can be used to help breathing, and when further respiratory failure occurs, tracheotomy and artificial respirator are required.