Amyotrophic Lateral Sclerosis - How is ALS Diagnosed?

Amyotrophic lateral sclerosis (ALS) is difficult tosmall shock is passed through the nerve to measure
diagnose early because it may appear similar to otherthe size and speed of nerve signals.
neurological diseases. No test can provide a definite- Imaging. A doctor may suggest magnetic resonance
diagnosis of ALS, although the presence of upper andimaging (MRI) or a computerized tomography (CT)
lower motor neuron signs in a single limb is stronglyscan to produce brain and spinal cord images. These
suggestive. Instead, the diagnosis of ALS is primarilytests can help the doctor determine if something
based on the symptoms and signs the physicianother than ALS may be causing the signs and
observes in the patient and a series of tests to rulesymptoms.
out other diseases. Physicians obtain the patient's full- Spinal tap (lumbar puncture). This test analyzes the
medical history and usually conduct a neurologiccerebrospinal fluid surrounding the brain and spinal
examination at regular intervals to assess whethercord. A needle is inserted into the spinal canal to
symptoms such as muscle weakness, atrophy ofcollect fluid. Tests on this fluid indicate the number
muscles, hyperreflexia, and spasticity are gettingand types of white blood cells, the level of sugar, and
progressively worse.the levels and types of proteins. Additional tests on
Diagnostic tests for ALS may include:this fluid can indicate evidence of bleeding, infection
- Electromyogra (EMG). Electromyography measuresand abnormal cells.
the tiny electrical discharges produced in muscles. A- Blood and urine tests. Analyzing samples of blood
thin-needle electrode is inserted into the muscles theand urine in the laboratory may help the doctor
doctor wants to study. An instrument records theeliminate other possible causes of signs and
electrical activity in the muscle as it rests andsymptoms.
contracts.- Muscle biopsy. If the doctor detects muscle disease
- Nerve conduction study (NCS). As part of anrather than ALS, the doctor may recommend a
electromyography study, two electrodes are tapedmuscle biopsy. In this procedure, a small portion of
to skin above a nerve or muscle to be studied. Atissue is removed and sent to a lab for analysis.