Abstract
In December 2006 an expert group of EMG and ALS specialists met in Awaji Island, Japan, to reconsider the role of clinical neurophysiology in the diagnosis of ALS. First, the importance of conventional electromyography and electroneurography was confirmed. Furthermore, it was recommended that electromyographical signs of denervation should be regarded as being equivalent to clinical signs.It was also recommended that fasciculation potentials in the clinical setting of an ALS should be regarded as an indication of active denervation similarly to positive waves and fibrillation potentials. The special diagnostic impact of unstable motor unit potentials was stressed. In summary, these considerations would render the diagnostic category of “laboratory-supported probable ALS” superfluous. Concerning the involvement of the upper motoneuron, the experts’ opinion was that further studies to evaluate new variations of transcranial magnetic stimulation such as the triple-stimulation technique are necessary.
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