Shortening the time to diagnosis in ALS: the role of electrodiagnostic studies

The early diagnosis of ALS has become an issue in management of the disease with the introduction of a therapy. As more effective treatment becomes available early diagnosis will become increasingly important. Electromyography (EMG) has potential value in this area, but will need to be applied not only with conventional methods but also quantitatively in order to refine the accuracy of diagnosis itself, and to evaluate progression. If a treatment is effective then progression will not occur and one of the major cornerstones of current diagnosis will disappear. For early diagnosis much will depend on appropriate recognition of the possibility of amyotrophic lateral sclerosis by primary care physicians, and other specialists. A semi-quantitative evaluation, utilizing clinical and EMG assessments, would help in this appraisal.