ALS - About Your Visit

What to expect from your doctor

Your doctor will carefully review your medical history, your family's medical history and your signs and symptoms. Your neurologist will conduct a comprehensive physical and neurological examination, which includes testing:

  • Muscle strength and tone
  • Reflexes
  • Coordination
  • Balance
  • Sense of touch, sense of light

Tests your doctor may request to help make a diagnosis

ALS may seem similar to other neurological diseases so it is important to rule them out. The following tests may be recommended by your doctor to evaluate for other diseases:

  • Electromyography (EMG) – An EMG can help detect abnormalities in muscles and nerve cells that control them. An EMG may consist of both a nerve conduction study and a needle examination.
    • Nerve conduction study – This study measures your nerves' ability to send impulses to muscles to different parts of your body determining nerve damage.
    • Needle examination (EMG) – A doctor inserts a needle electrode through your skin into some muscles. This test evaluates the electrical activity of your muscles when they contract and when they're at rest. Muscles that appear abnormal can help your doctor determine if you have a muscle or nerve condition that may be causing your symptoms.
  • Magnetic resonance imaging (MRI) – An MRI can produce detailed images of your brain and spinal cord. An MRI will show spinal cord tumors, herniated disks in your neck or other conditions that may be causing your symptoms.
  • Spinal tap (lumbar puncture) – Sometimes a specialist may remove a sample of your spinal fluid for analysis. In this bedside procedure, a numbing medicine will be applied to the skin of your back. Then a small needle will be inserted between two vertebrae in your lower back to remove a small amount of cerebrospinal fluid for testing.
  • Muscle biopsy – A muscle biopsy is very rarely needed to rule out ALS. A small portion of your muscle is removed (biopsied) and sent to a lab for analysis. You would be under local anesthesia for this procedure.
  • Blood and urine tests – Blood or urine test in the laboratory may help your doctor rule out other possible causes of your signs and symptoms.