Demographics, characteristics, and clinical profile of motor neuron disease in oman
Authors: Al Salti Abdullah M , Nadeem Ahmed SM , Arun Sanjith , Shaikhly Khalil I AJ Al , Fatehi Farzad 
Published: January 2025

Background: Motor neuron disease (MND) presents a considerable health challenge globally
and is characterized by progressive neurodegeneration leading to debilitating weakness and
eventual respiratory failure. Despite its impact, studies on MND from the Middle East and
North Africa region are scarce. Considering the seriousness of the disease, it is important to
recognize the demographics, clinical spectrum, and heterogeneity of MND cases to enable
early diagnosis and the prompt initiation of supportive interventions to improve survival,
quality of life, and physical functioning as there are presently no therapies to arrest or reverse
this fatal disease.
Objective: This study aimed to elucidate the demographics, clinical characteristics, management strategies, and outcomes of MND in Omani patients admitted and/or referred to a single
tertiary care hospital in Muscat, Oman.
Methods: A total of 29 patients diagnosed with MND who were treated and followed up at
the neuromuscular disorders clinic, Khoula Hospital, Muscat, Oman, between January 2016
and April 2020 were retrospectively reviewed. Data collection and analysis included patient
demographics, site of onset, duration of symptoms, clinical features, and the results of diagnostic workup. The initial primary diagnosis, clinical course follow-up, and treatments and
supportive interventions were also reviewed. Furthermore, outcome measures and survival
were recorded.
Results: The patients had a male-to-female ratio of 1.23:1, a mean age of symptom onset of
54.7±12.7 years, and a mean duration of the disease from its onset to diagnosis of 20.3±20.9
months. Most patients (69%) presented with significant limb muscle weakness at diagnosis,
with an overall revised amyotrophic lateral sclerosis functional rating scale of 35.14±10.49.
MND was considered initially in 21% of the cases, while the most common primary diagnoses were cervical and lumbosacral radiculopathy (in 34% of the cases). The classic amyotrophic lateral sclerosis of spinal onset (cervical and lumbar) was the most common clinical
phenotype (in 41.4% of the studied patients). The mean duration of follow-up was 48 months,
and by the end of the study, 27.6% of the patients with MND were on mechanical ventilation
(invasive and noninvasive), 34.5% had parenteral tube feeding, and 86% were on treatment
with riluzole. Survival analysis revealed gender-related differences, with females exhibiting
shorter survival times than males (26 vs. 42 months).
Conclusion: As a novel, comprehensive report on the Omani MND population, this study
revealed that the epidemiological and clinical characteristics of the disease in Oman were
similar to those observed in international populations. However, our study indicated a higher
survival rate because of the early initiation of supportive interventions. In addition, this study
showed that Omani women had a longer duration of diagnostic delay and a shorter median
survival time than men. We suggest a longer-term (5–10 year follow-up) multicenter study
involving local and regional centers to include a larger number of patients with MND for
obtaining a better understanding of the disease in this region.