ALS is a neurodegenerative disease that affects the motor neurons of your brain and spinal cord, which makes you start losing control of your voluntary muscles such as walking, eating, breathing, chewing, etc. This disease is also called Lou Gehrig’s disease. Over time this disease makes it extremely hard to walk, eat, and breathe. And in most cases, death happens due to not being able to breathe. If you are diagnosed early, prompt treatment makes life a little bit easier by controlling its symptoms and complications.  

 Diagnosis 

You might need to go through multiple tests to get confirmation from the doctor that you have ALS or not. The tests are as follows:  

1. Neurological exam: A typical neurological exam includes details about your family, work, and environmental histories. During this test, the neurologist tries to note the specific symptoms of ALS which include: 
   • Muscle weaknesses (a muscle of your one hand, arm, leg, foot, slurred voice, or slow speech). This exam also evaluates the muscles of your mouth, tongue, and the muscles that help in chewing or swallowing.  
   • They check lower motor neuron features such as muscle shrinkage or twitches. These kinds of twitches are called fasciculations which happen when neurons are not able to fully control the muscles.  
   • They also check upper motor neuron features such as hyperactive reflexes and muscle spasticity (a type of tightness and rigidness of the muscles). 
   • This exam also helps to diagnose emotional changes such as uncontrollable laughter and crying. This exam also checks changes in thinking (such as loss of judgment, or loss of common social skills). The examiner also checks if you can solve problems in verbal fluency or word recognition abilities. Although, these types are less present or less noticeable. 
   • Also, neurologists look for signs of pain, loss of sensation, extrapyramidal rigidity, etc. To notice any signs and symptoms of ALS.  
2. EMG (Electromyography): This is one of the important tests to diagnose ALS. In this test, the first doctor sends small electrical shocks through your nerves to see how fast your brain can conduct electricity and whether there are any damaged nerves. This shock might feel like static electricity but is sometimes much stronger.  After this first test, in the second test, they check the electrical activity of selected muscles. This is not done by electric shocks but by putting a needle into selected muscles and detecting the electrical patterns of your muscles. In both tests, your doctor can clearly see any abnormal activity if you have ALS.  
3. Nerve conduction: This test is used to measure the ability of your nerves to transmit impulses by sending impulses to muscles into various parts of the body. This test tells you whether your nerve has been damaged or not. Only 10% of ALS patients have abnormal nerve conduction according to a study, but a nerve conduction abnormality suggests further diagnostic tests.  
4. MRI: MRIs offer a clear picture of your brain and spinal cord. This is a painless process using radio waves and a powerful magnetic field. It shows more details than CAT or X-rays. With the help of MRI, you can reveal multiple sclerosis, tumors, herniated disks, and bone abnormalities that cause the symptoms in your nerves.  
5. Blood and urine tests: These tests help the doctor to eliminate the possibility of having other diseases besides ALS. These tests include thyroid and parathyroid disease, vitamin B12 deficiency, HIV (Human Immunodeficiency Virus), Hepatitis, auto-immune diseases, and some types of cancer.  
6. Spinal tap: Sometimes doctors perform a Spinal tap or lumbar puncture. This test is only necessary when an individual has unusual features of ALS such as spinal nerve abnormalities or has no sign of abnormal reflexes or spasticity. To do this test, the examiner inserts a needle into the lower part of your spinal cord to remove fluid to examine abnormal cells.  
7. Muscle biopsy: This test happens when the doctor thinks that you do not have ALS but some muscle disease. So, the doctor gives you anesthesia and removes the tissue of your muscles, and sends it for analysis. 
8. Genetic testing: This test is done rarely, only in the case of juvenile spinal muscle atrophy. This test is only performed when someone else in the family also has ALS.

ALS is a neurological disease that makes life hard and eventually leads to death. But early diagnosis and treatment make you survive longer with some ease. 

Want to know more about the treatment of ALS that can make your life easier? 

At Doral Health and Wellness, we have doctors that can help you manage your condition. For more information, you can visit us at 1797 Pitkin Avenue, Brooklyn, New York, 11212, or call us at 1-347-384-5690. You can also visit our website at https://doralhw.org or contact us at info@doralhw.org if you have any queries.