Diagnosing ALS and learning about the disease process

Today, there is no current test that is done to diagnosis Amyotrophic Lateral Sclerosis, and the disease is very hard to diagnose. Only through a thorough clinical examination and series of diagnostic tests, that help to rule out other diseases that may mimic ALS, can be done to establish the disease.
The presence of upper and lower motor neuron signs is strongly suggestive to ALS. Once these are evaluated by the physician, they can order a series of tests to help eliminate other diseases and further suggest the diagnosis of ALS. Some of these tests are listed below.

• Electrodiagnostic tests including electomyography (EMG) - a special recording technique that detects electrical activity in the muscles
• Nerve conduction velocity (NCV) which measures electrical energy by assessing the nerve's ability to send a signal
• Blood and urine sample studies include high resolution serum protein electrophoresis, thyroid and parathyroid hormone levels and 24-hour urine collection for heavy metals
• Spinal tap
• X-rays, including magnetic resonance imaging (MRI) to get detailed images of the brain and spinal cord. These could reveal evidence of other problems that may be causing the symptoms, such as a spinal cord tumor, a herniated disk in the neck that suppresses the spinal cord, or even a cyst in the spinal cord.
• Myelogram of cervical spine - an imaging test that looks for problems in the spinal canal, including the nerve roots and other tissues.
• Muscle and/or nerve biopsy,
• Thorough neurological examination

There are several diseases that share the same symptoms of ALS and are all treatable. The ALS association recommends that patients diagnosed with ALS receive a second opinion from an "ALS expert" - someone who diagnoses and treats many patients with ALS and has training in this medical specialty.

The ALS Association. (2010, January 1). Diagnosing ALS. Retrieved January 30, 2015, from http://www.alsa.org/about-als/diagnosing-als.html