ALS: About Your Visit

What to expect from your doctor

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

ALS Center for Excellence Older Male Patient with Tech Photo
  • Muscle strength and tone
  • Reflexes
  • Coordination
  • Balance
  • Sense of touch, sense of light

Tests and Diagnosis of Possible Neurological Issues

ALS may seem similar to other neurological diseases. The following tests help rule out other conditions, including:

  • Electromyogram (EMG) – An EMG (electromyography) can help detect abnormalities in muscles and nerve cells that control them. An EMG may consist of 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 may seem 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 may very rarely be 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.