Amyotrophic lateral sclerosis diagnostic study of choice: Difference between revisions

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Latest revision as of 16:46, 15 September 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

ALS is a clinical diagnosis. Due to the absence of any disease bio-markers, the presence of both UMN and LMN signs and symptoms in the same body region along with the progression of these symptoms. Modified El-Escorial diagnostic criteria are used for elucidation of electrophysiological changes for the diagnosis of ALS. El- Escorial criteria are also known as Airlie House recommendations. It was revised in a meeting at Awaji Island, Japan in 2006. Current Airlie house recommendations were revised step by step. Awaji criteria have a significant impact on the early diagnosis of ALS. Currently, Gold coast criteria are used for the diagnosis of ALS.

Diagnostic Study of Choice

Name of Diagnostic Criteria

Awaji Criteria for the diagnosis of ALS was proposed to facilitate the diagnosis of ALS in the early stage.

Major points include:

Electromyography is considered equivalent to the clinical examination of the identification for LMN signs and fasciculations.

^[1]

Both Awaji and El-escorial criteria are complicated to apply for the diagnosis of ALS and also prone to errors.

For all these reasons 'Gold coast criteria were established to modify the existing criteria and to simplify the diagnosis of ALS.

Key points of Gold coast criteria are:

1. Progressive motor degeneration documented by history/repeated clinical evaluation, with previously normal motor function, and

2. Presence of upper and lower motor neuron dysfunction in at least one body region, (with upper and lower motor neuron dysfunction noted in the same body region) or lower motor neuron dysfunction in at least two body regions, and

3. Key Investigations (EMG, imaging, etc) that exclude other disease processes.

^[2]

References

↑ Guennoc AM, Camu W, Corcia P (2013). "[Awaji criteria: new diagnostic criteria for amyotrophic lateral sclerosis]". Rev Neurol (Paris). 169 (6–7): 470–5. doi:10.1016/j.neurol.2012.10.007. PMID 23261262.
↑ Shefner JM, Al-Chalabi A, Baker MR, Cui LY, de Carvalho M, Eisen A; et al. (2020). "A proposal for new diagnostic criteria for ALS". Clin Neurophysiol. 131 (8): 1975–1978. doi:10.1016/j.clinph.2020.04.005. PMID 32387049 Check |pmid= value (help).

Template:WH Template:WS

[pmid23261262-1] Guennoc AM, Camu W, Corcia P (2013). "[Awaji criteria: new diagnostic criteria for amyotrophic lateral sclerosis]". Rev Neurol (Paris). 169 (6–7): 470–5. doi:10.1016/j.neurol.2012.10.007. PMID 23261262.

[pmid32387049-2] Shefner JM, Al-Chalabi A, Baker MR, Cui LY, de Carvalho M, Eisen A; et al. (2020). "A proposal for new diagnostic criteria for ALS". Clin Neurophysiol. 131 (8): 1975–1978. doi:10.1016/j.clinph.2020.04.005. PMID 32387049 Check |pmid= value (help).

[1]

[2]

@@ Line 3: / Line 3: @@
 {{CMG}}; {{AE}}{{MMJ}}
 == Overview ==
+ALS is a clinical diagnosis. Due to the absence of any disease bio-markers, the presence of both UMN and LMN signs and symptoms in the same body region along with the progression of these symptoms. Modified ''El-Escorial'' diagnostic criteria are used for elucidation of electrophysiological changes for the diagnosis of ALS. El- Escorial criteria are also known as ''Airlie House recommendations''. It was revised in a meeting at Awaji Island, Japan in 2006. Current Airlie house recommendations were revised step by step. Awaji criteria have a significant impact on the early diagnosis of ALS. Currently, Gold coast criteria are used for the diagnosis of ALS.
 == Diagnostic Study of Choice ==
-=== Study of choice ===
-[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
-OR
-The following result of [gold standard test] is confirmatory of [disease name]:
-* [Result 1]
-* [Result 2]
-OR
-[Name of the investigation] must be performed when:
-* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
-* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
-OR
-[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
-OR
-The diagnostic study of choice for [disease name] is [name of the investigation].
-OR
-There is no single diagnostic study of choice for the diagnosis of [disease name].
-OR
-There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
-OR
-[Disease name] is primarily diagnosed based on the clinical presentation.
-OR
-Investigations:
-* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
-* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
-* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
-==== The comparison of various diagnostic studies for [disease name] ====
-{|
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-|}
-<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
-===== Diagnostic results =====
-The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
-* [Finding 1]
-* [Finding 2]
-===== Sequence of Diagnostic Studies =====
-The [name of investigation] must be performed when:
-* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
-* A positive [test] is detected in the patient, to confirm the diagnosis.
-OR
-The various investigations must be performed in the following order:
-* [Initial investigation]
-* [2nd investigation]
 === Name of Diagnostic Criteria ===
+* Awaji Criteria for the diagnosis of ALS was proposed to facilitate the diagnosis of ALS in the early stage.
+Major points include:
+* Electromyography is considered equivalent to the clinical examination of the identification for LMN signs and fasciculations.
+<ref name="pmid23261262">{{cite journal| author=Guennoc AM, Camu W, Corcia P| title=[Awaji criteria: new diagnostic criteria for amyotrophic lateral sclerosis]. | journal=Rev Neurol (Paris) | year= 2013 | volume= 169 | issue= 6-7 | pages= 470-5 | pmid=23261262 | doi=10.1016/j.neurol.2012.10.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23261262  }} </ref>
-'''It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.'''
+*Both Awaji and El-escorial criteria are complicated to apply for the diagnosis of ALS and also prone to errors.
-[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
-OR
-There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
-OR
-The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-OR
-The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
-OR
-[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
-* Criteria 1
-* Criteria 2
-* Criteria 3
-OR
-'''IF there are clear, established diagnostic criteria'''
-The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-OR
-The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
-OR
+* For all these reasons '''Gold coast criteria'' were established to modify the existing criteria and to simplify the diagnosis of ALS.
+Key points of Gold coast criteria are:
-The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
+. Progressive motor degeneration documented by history/repeated clinical evaluation, with previously normal motor function, and
-OR
+. Presence of upper and lower motor neuron dysfunction in at least one body region, (with upper and lower motor neuron dysfunction noted in the same body region) or lower motor neuron dysfunction in at least two body regions, and
-'''IF there are no established diagnostic criteria'''
+. Key Investigations (EMG, imaging, etc) that exclude other disease processes.
-There are no established criteria for the diagnosis of [disease name].
+<ref name="pmid32387049">{{cite journal| author=Shefner JM, Al-Chalabi A, Baker MR, Cui LY, de Carvalho M, Eisen A | display-authors=etal| title=A proposal for new diagnostic criteria for ALS. | journal=Clin Neurophysiol | year= 2020 | volume= 131 | issue= 8 | pages= 1975-1978 | pmid=32387049 | doi=10.1016/j.clinph.2020.04.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32387049  }} </ref>
 ==References==