Forms of ALS

HOW IS ALS DIAGNOSED?

ALS diagnosis is difficult to assess in the early stages because symptoms may mimic other conditions. Moreover, there is no ALS-specific test, wich means that ALS is diagnosed by ruling out other possible conditions. However, there are clinical signs that can indicate wasting of motor neurons in either the upper or lower portion of the spine.

Doctors familiar with ALS can, however, group together seemingly contradictory clinical indications and make a diagnosis sooner. In the early stages of their development, all motor neuron diseases have similar symptoms, which can delay a clear and categorical diagnosis. Doctors assess the first visible signs of ALS by performing clinic examinations and a series of diagnostic tests to eliminate common indicators of motor neuron disease. As the symptoms evolve — a process that can vary from one person to another — they converge into a precise form of motor neuron damage. In the case of ALS, detecting the presence of several categories of clinical indicators becomes increasingly relevant to support an ALS diagnosis.

Lower Motor neuron degeneration:

  • muscle weakness and atrophy
  • involuntary twitching of muscle fibres
  • involuntary twitching of muscle fibres
  • muscle cramps
  • weakened reflexes
  • flaccidity (decreased muscle tone)
  • difficulty swallowing
  • inability to articulate speech
  • shortness of breath at rest

Upper Motor neuron degeneration:

  • muscle stiffness, or rigidity
  • muscle stiffness, or rigidity
  • emotional lability (decreased ability to control laughing or crying)
  • increased or hyperactive reflexes

Some may assume that these are signs of normal aging. Over time, as muscles continue to weaken, and the weakening spreads throughout the body, it becomes more apparent that the cause is ALS. In addition to a physical examination, people are often given an electromyography (EMG) test, blood tests, an MRI (Magnetic Resonance Imaging), and other tests to search for the presence of other diseases that can look like ALS.

Many doctors, including neurologists, do not have experience with recognizing and treating ALS. It is best to find out who in your province is familiar with
ALS as soon as possible. Often patients are sent to ALS specialists to confirm a diagnosis and tell the patient they have ALS.

To date, there is no ALS-specific diagnostic test. Because ALS symptoms are similar to those of other diseases (neurological or others) or even resemble the signs of aging, your family doctor may have to test you for other diseases and conditions to rule them out before making a diagnosis.

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