Electrodiagnostic criteria for diagnosis of ALS.
A consensus meeting was held to determine the best use and interpretation of electrophysiological data in the diagnosis of ALS. The utility of needle EMG and nerve conduction studies was affirmed. It is recommended that electrophysiological evidence for chronic neurogenic change should be taken as equivalent to clinical information in the recognition of involvement of individual muscles in a limb. In addition, in the context of a suspected clinical diagnosis of ALS, fasciculation potentials should be taken as equivalent to fibrillation potentials and positive sharp waves in recognising denervation. The importance of searching for instability in fasciculation potentials and in motor unit potentials in ALS is stressed. These changes in the interpretation of electrophysiological data render obsolete the category Probable Laboratory-Supported ALS in the modified El Escorial diagnostic criteria for ALS. Methods for detection of upper motor neuron abnormality appear sensitive but require further study, particularly regarding their value when clinical signs of upper motor neuron lesion are uncertain.
de Carvalho
Mamede
M
Department of Neurology, Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal.
Dengler
Reinhard
R
Department of Neurology, Medizinische Hochschule Hannover, Germany.
Eisen
Andrew
A
Department of Neurology, University of British Columbia, Vancouver, Canada.
England
John D
JD
Department of Neurology, Billings Clinic, Billings, MT, USA.
Kaji
Ryuji
R
Department of Neurology, Tokushima University Graduate School of Medicine, Tokushima-city, Japan.
Kimura
Jun
J
Department of Neurology, University of Iowa, Iowa City, USA.
Mills
Kerry
K
Department of Neurology, Kings College Hospital, Guys Kings and St. Thomas's School of Medicine, London, UK.
Mitsumoto
Hiroshi
H
Eleanor and Lou Gehrig ALS Center, Neurological Institute, Columbia University, NY, USA.
Nodera
Hiroyuki
H
Department of Neurology, Tokushima University, Tokushima-city, Japan.
Shefner
Jeremy
J
Department of Neurology, Upstate Medical University, Syracuse, NY, USA.
Swash
Michael
M
Department of Neurology, Royal London Hospital, Queen Mary University of London, London, UK. Electronic address: mswash@btinternet.com.
D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis*; D004568:Electrodiagnosis / Q000379:methods* / Q000592:standards*