- 1). Perform an electromyogram to measure the minute electrical discharges that muscles produce. Place a wire electrode into specific muscle groups. The muscle's electrical activity is documented while the muscle is contracted and rested.
- 2). Measure the nerve signals' strength and speed through a nerve conduction study. Hook electrodes to the skin that lies over a particular nerve or muscle, and then discharge a small electric shock.
- 3). Take an image of the brain and spinal cord by using magnetic resonance imaging (MRI). Combine a series of radio waves with a strong magnetic field to yield detailed pictures of both.
- 4). Analyze the cerebrospinal fluid that surrounds the brain and spinal cord by using a spinal tap or a lumbar puncture. After the lower spine is anesthetized (to minimize any discomfort), place a needle into the spinal canal and draw spinal fluid. Allow 45 minutes for the actual procedure and another 30 minutes to an hour lying in a prone position.
- 5). Eliminate the possibility of other medical conditions with similar symptoms by taking take blood and urine samples. Examine these samples for high resolution serum protein electrophoresis or specific proteins in the blood; thyroid and parathyroid levels; and 24-hour urine collection for heavy metals associated with lead poisoning.
- 6). Get a biopsy of the muscle after the patient is anesthetized. Remove the sample and send it to the laboratory for analysis.
- 7). Consider genetic testing if there is a family history of ALS and some or all of the symptoms are being exhibited. This type of testing is not a fail-safe predictor of the disease. It may, however, be able to determine if an individual is genetically predisposed to ALS.
- 8). Recommend that your patient seek out a second medical opinion since numerous other diseases produce similar symptoms, many of which can be treated.
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