According to the ALS Association, ALS is not easy to diagnose and there is no one test or procedure to ultimately establish a diagnosis. One needs a thorough clinical examination as well as a series of diagnostic tests, often ruling out other diseases that mimic ALS.
A comprehensive diagnostic workup includes most, if not all, of the following procedures:
- electrodiagnostic tests including electomyography (EMG) and nerve conduction velocity (NCV)
- blood and urine studies including high resolution serum protein electrophoresis, thyroid and parathyroid hormone levels and 24 hour urine collection for heavy metals
- spinal tap
- x-rays, including magnetic resonance imaging (MRI)
- myelogram of cervical spine
- muscle and/or nerve biopsy
- thorough neurological examination
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