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Tests and diagnosis
By Mayo Clinic staffAmyotrophic lateral sclerosis is difficult to diagnose early because it may appear similar to several other neurological diseases. Tests to rule out other conditions may include:
- Electromyogram. This test measures the tiny electrical discharges produced in muscles. A fine wire electrode is inserted into the muscles that your doctor wants to study. An instrument records the electrical activity in your muscle as you rest and contract the muscle. This test is mildly uncomfortable for most people.
- Nerve conduction study. For this test, electrodes are attached to your skin above the nerve or muscle to be studied. A small shock is passed through the nerve to measure the strength and speed of nerve signals.
- MRI. Using radio waves and a powerful magnetic field, MRI can produce detailed images of your brain and spinal cord. It involves lying on a movable bed that slides into a tube-shaped machine, which makes loud thumping and banging noises during operation. Some people feel uncomfortable in the confined space.
- Spinal tap (lumbar puncture). This test analyzes the fluid surrounding your brain and spinal cord (cerebrospinal fluid). You typically lie on your side with your knees drawn up to your chest. A local anesthetic is injected in an area over your lower spine to reduce any discomfort from the procedure. Then a needle is inserted into your spinal canal, and fluid is collected.
- Blood and urine tests. Analyzing samples of your blood and urine in the laboratory may help your doctor eliminate other possible causes of your signs and symptoms.
- Muscle biopsy. If your doctor believes you may have a muscle disease rather than ALS, you may undergo a muscle biopsy. In this procedure, a small portion of muscle is removed while you're under local anesthesia and is sent to a lab for analysis.
References
- Amyotrophic lateral sclerosis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/amyotrophiclateralsclerosis/detail_amyotrophiclateralsclerosis.htm. Accessed Sept. 18, 2008.
- Elman LB, et al. Clinical features of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 18, 2008.
- Maragakis NJ, et al. Epidemiology and pathogenesis of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 18, 2008.
- McCluskey L. Familial amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 18, 2008.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Sept. 19, 2008.
- ALS in the military: Unexpected consequences of military service. ALS Association. http://www.alsa.org/files/pdf/als_military_paper.pdf. Accessed Sept. 19, 2008.
- Elman LB, et al. Diagnosis of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 19, 2008.
- Galvez-Jimenez N, et al. Symptom-based management of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 19, 2008.
- Choudry RB, et al. Pharmacologic treatment of amyotrophic lateral sclerosis. http://www.uptodate.com/home/index.html. Accessed Sept. 19, 2008.
- Why is exercise important? In: Everyday Life With ALS: A Practical Guide. Muscular Dystrophy Association. http://www.als-mda.org/publications/everydaylifeals/ch8/. Accessed Sept. 19, 2008.
- Radunovic A, et al. Clinical care of patients with amyotrophic lateral sclerosis. Lancet Neurology. 2007;6(10):913-925.
- Lyon M. Reasons for living with ALS. ALS Association. http://www.alsa.org/patient/living.cfm?CFID=1025297&CFTOKEN=f8c064e9dbbd397-7B4C955C-188B-2E62-8049290070F4DFA9. Accessed Sept. 19, 2008.
- Good practice in the management of amyotrophic lateral sclerosis: Clinical guidelines. An evidence-based review with good practice points. Umea, Sweden: EALSC Working Group. Amyotrophic Lateral Sclerosis. 2007;8:195-213.
- Crum BA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 21, 2008.
