ALS is a difficult disease to diagnose. There is no one test or procedure to ultimately establish the diagnosis of ALS. It’s only through a clinical examination and series of diagnostic tests, often ruling out other diseases that mimic ALS, that a diagnosis can be established.
A comprehensive diagnostic workup includes most, if not all, of the following procedures:
- Electrodiagnostic tests, including electomyography (EMG) and nerve conduction velocity (NCV)
- Blood and urine studies, including 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)
- Myelogram of cervical spine
- Muscle and/or nerve biopsy
- A thorough neurological examination
These tests are done at the discretion of the physician, usually based on the results of other diagnostic tests and the physical examination. Several diseases have some of the same symptoms as ALS, and most of those conditions are treatable. Our ThinkALS tool was designed to help physicians diagnose the disease as early as possible.
The ALS Association recommends that a person diagnosed with ALS seek a second opinion from an ALS expert – someone who diagnoses and treats many ALS patients and has training in this medical specialty.
The ALS Association maintains a list of recognized experts in the field of ALS. See The ALS Association Certified Centers and ALS Clinics page for more information and/or contact your local ALS Association chapter or the National Office.