Diagnosis of ALS Sample Clauses

Diagnosis of ALS. Diagnosis of ALS takes on average a year, likely due to a combination of time-consuming factors such as referral to specialist centres, exclusion of ALS mimics and the need to show the disease is progressing (Xxxxxxxx, Xxxxxx, & Xxxxx, 2020). This is compounded by the lack of a diagnostic test, and the lack of an effective therapy for what is a devastating diagnosis, so that doctors wait until they are very certain of the diagnosis before referral. The diagnosis is clinical, meaning it is based on symptoms of motor neuron involvement, patient history and negative tests for other motor disorders. In some cases, genetic testing may be undertaken as part of diagnosis, but this is usually for people with a reported positive family history and does not replace clinical diagnostic workup (Xxxxxxx et al., 2020). The El Escorial criteria, and their Xxxxx House and Awaji revisions are used as a diagnostic framework for ALS, and are detailed in table 1.1 (Xxxxxx, 1994; Xxxxxx, Xxxxxx, Xxxxx, & Xxxxxx, 2000; xx Xxxxxxxx et al., 2008). They have now been superseded by the Gold Coast Criteria (Xxxxxxx et al., 2020). A simplification of these criteria is that, the body is divided into central nervous system regions (upper limb, lower limb, bulbar and thoracic) and depending on the number of regions with presence of upper and or lower motor neuron symptoms people are assigned diagnostic categories. A recent revision, the Awaji criteria, categorises people as having Possible, Probable or Definite ALS (xx Xxxxxxxx et al., 2008). The revisions have clarified acceptable lower motor neuron signs and improved on diagnostic accuracy (both sensitivity and specificity) (Boekestein, Kleine, Xxxxxxx, Xxxxxxxxx, & Xxxxxx, 2010; Xxxxxxx et al., 2019). However, the category nomenclature does not reflect diagnostic certainty, interrater reliability is low, and people with PLS may be included (Xxxxxxx et al., 2019; Xxxxxxx et al., 2020). To address these limitations, and to simplify the diagnostic categories into a minimum criterion needed to be diagnosed with ALS, the ‘Gold Coast Criteria’ have been developed (Xxxxxxx et al., 2020). If someone has progressive motor impairment, upper and lower motor neuron symptoms in one body region or lower motor neuron symptoms in two body regions and other causes have been excluded then they meet minimum diagnostic criteria. The Gold Coast Criteria represent a consensus of experts and the diagnostic category is not yet clinically validated. The curr...
Sample 1
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Related to Diagnosis of ALS

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