The term “motor neuron disease” (MND) in a narrow sense refers to “amyotrophic lateral sclerosis” (ALS), so the treatment mentioned here refers to the treatment of ALS. The basic idea of Western medicine in treating any disease is to identify the cause and pathogenesis of the disease and treat it according to the cause and pathogenesis. For example, the cause of bacterial pneumonia is bacterial infection, so the basic treatment principle is antibiotics to kill the bacteria. The pathogenesis of ALS is not clear, and this is the fundamental reason why there is no definitive and targeted treatment in Western medicine. Although the pathogenesis is unclear, it is believed that the common pathological processes include “oxidative damage”, “excitatory amino acid toxicity”, and “mitochondrial dysfunction”. The current treatment is also aimed at these aspects. Riluzole is an excitatory amino acid antagonist that targets the mechanism of “excitatory amino acid toxicity”, which is the only drug that has been clinically proven to slow down the progression of ALS. In 1994, Bensimon G published the first small randomized, double-blind controlled study of riluzole in ALS in the prestigious New England Journal of Medicine. In 1996, the results of two large clinical trials were published in Neurology, both of which showed that riluzole appropriately prolonged the survival of patients. In the same year, another study in the Lancet compared the effects of different doses of riluzole and showed that a dose of 100 mg/d was the most effective and best tolerated by patients. 50 mg/d was also effective but not as good as 100 mg/d, while 200 mg/d had too many side effects for patients to tolerate. The side effects of 200 mg/d are too great for patients to tolerate. Over the past 20 years, basic and clinical studies have continued to demonstrate that riluzole can appropriately delay patient survival. However, its effect is limited to slowing down the progression of the disease, but not reversing it, and it is difficult to stop the progression of the disease or to restore the patient’s strength. This is something that must be very clear before taking the drug. Since this drug is expensive, we suggest that if the patient’s economic condition allows, a dose of 100mg/d (50mg/time, 2 times/day) should be used, and no other medication or food should be taken 1 hour before or after taking the drug. If economic conditions are not favorable, a dose of 50 mg/d (25 mg/dose, 2 times/day) may be used. Various studies have shown that the earlier this drug is used, the more effective it is, and it is no longer recommended for patients who have progressed to advanced stages. Therefore, early diagnosis and early treatment are crucial. Riluzole may cause abnormal liver function in a small number of patients, so it is important to test liver function 1 month after taking the drug and to review it regularly thereafter. If the liver function is more than 3 times the upper limit of normal, further use is not recommended. In addition, muscle weakness is significantly aggravated in a small number of patients after taking the drug, and this group of patients should not continue to use it. For patients who cannot take riluzole for various reasons, high-dose “vitamin C + vitamin E + coenzyme Q10 + levocarnitine” can be used. High-dose vitamin C and vitamin E are strong antioxidants that target the “oxidative damage” mechanism, while “coenzyme Q10 + levocanidine” is a mitochondrial function protector that targets the latter mechanism. This combination is theoretically effective but has not been clinically proven. The advantages are that it is inexpensive, has few side effects and is well tolerated by patients. In addition to medications, there are two other points that need special attention in ALS patients, which are even more important than medications: ensuring nutritional supply and oxygen supply; ALS is a high-consumption disease, and once nutritional deficiencies or reduced oxygen supply occur, the disease can progress rapidly. Therefore, patients should eat a high-calorie, high-protein diet without MSG, chicken, or any other flavors, and should not take “lipid-lowering drugs”. To ensure that the weight does not decrease or even slightly increase. If the patient’s weight is more than 10% lower than before the onset of the disease, or if it takes more than 30 minutes to eat, consider a “gastrostomy”, which is a tube placed in the abdominal wall through a gastroscope to feed through the fistula. Although it sounds scary, the actual operation and care is not complicated, and patients usually do not have significant discomfort, but the bathing is somewhat affected. The fistula can be replaced once a year. If the patient’s condition has progressed to a certain point, symptoms such as breath-holding and shortness of breath may occur, at which point a pulmonary function test should be performed, and if the FVC value is less than 75%, a non-invasive ventilator should be considered. Some patients ask whether oxygen can solve the problem, but the answer is no. Patients with ALS cannot breathe in and out of the lungs due to the weakness of the respiratory muscles, and oxygen inhalation cannot get oxygen into the lungs. A non-invasive ventilator can help the patient increase the amplitude and depth of inhalation and exhalation to complete the gas exchange. Since the patient has problems with breathing, it is important to choose a bi-level non-invasive ventilator. It can be used for 1 hour per day at the beginning, and gradually increase the time and frequency of use after the patient tolerates it. Riluzole, ensuring nutritional supply (gastrostomy), and ensuring oxygen supply (non-invasive ventilator) are the three main treatments that have been shown to slow down the progression of the disease. In addition, there are symptomatic treatments that specifically improve symptoms. For example, “5hydroxytryptamine reuptake inhibitors” can be used for patients with combined anxiety, and newer anti-insomnia drugs such as “Zopiclone” or “Synthroid” can be used for patients with insomnia, but the use of tranquilizers is not recommended. The use of tranquilizers is not recommended, as the latter can aggravate muscle weakness and inhibit breathing. Amitriptyline or 654-2 can be used to reduce saliva secretion, the former also has anti-anxiety and depression effects, but these drugs have more side effects and are recommended to be used under medical supervision. Patients with pain can use non-steroidal anti-inflammatory drugs such as “Fenbid”. Patients with sputum that cannot be easily coughed up can use phlegmolytic drugs and coughing machines to assist in coughing up sputum. Various clinical trials have been conducted to investigate the possible mechanisms of ALS, including “lithium”, “ceftriaxone”, “colony cell stimulating factor”, “special types of immunomodulators” and “special types of immunomodulators”. “Special types of immunomodulators” and so on, but all of them have failed. This year’s annual ALS meeting reported that an oligonucleotide modulator called NP001 may be effective in ALS, but it has not been clinically validated on a large scale. Since the pathogenesis of ALS is still unclear to date, there is still a long way to go in terms of treatment. In particular, it should be noted that some of the so-called treatments and even cures for ALS have not been clinically proven, the most famous being “stem cell transplantation”. As early as 2008, the Ministry of Health issued a statement stating that China has not approved stem cell transplantation for any application other than the treatment of blood disorders. “Stem cell therapy” does have a promising future, but many problems in cell transplantation pathways, cell survival and growth differentiation pathways have not been solved, and success cannot be achieved simply by infusion or lumbar puncture or stereotactic transplantation. For the few state-approved, state-funded stem cell transplant studies, they are free of charge and families are fully informed of the possible risks they face. Currently, a few hospitals or doctors, however, advertise the effects of stem cell transplantation and attract patients to spend huge amounts of money on so-called stem cell transplantation, not only not seeing any results, but also suffering huge financial losses and most importantly, losing valuable time for treatment. Due to the special system in China, the health department cannot regulate these hospitals. Similarly, there are many self-invented so-called therapies, such as “nerve regeneration”, “nerve repair” and so on, all of which are aimed at recruiting patients and obtaining money as their first priority. In Chinese medicine, ALS belongs to the category of “impotence”, which is also a difficult condition to treat. If the diagnosis is accurate, we do not deny that Chinese medicine may be effective in treating ALS, nor do we object to combining Chinese and Western medicine. However, due to the subtlety of TCM, it is easy to be exploited, so patients should be reminded to go to a regular public tertiary hospital. The way to identify pseudo-Chinese medicine is that if the prescription is not given and the patient is not allowed to buy the medicine at the pharmacy by himself but only get the medicine at the hospital, it must be a fraud. In terms of life care, ALS patients should pay attention to appropriate activities, subject to non-exertion, do not engage in heavy exercise, avoid trauma, keep a happy mood and optimistic attitude is very helpful to slow down the development of the disease.