Background/Aim. Diagnosis of amyotrophic lateral
sclerosis (ALS) is based on combination of clinical signs
and electrophysiological correlates of pathological process which takes place in general. New electrophysiological criteria Awaji-Shima (AS) additionally qualify the
complex fasciculations and neurogenically modified potentials of motor units as signs of active lesions of peripheral motor neuron, contrary to previously valid revised El Escorial criteria (rEE). The objective of this research was to determine the clinical significance and advantages of using the AS criteria in patients with ALS.
Methods. Thirty patients (59.2 ± 10.9 years, 57% of
them with spinal form of the disease) with clinically
suspected ALS were monitored from the time of diagnosis until reaching the category of definitive diagnosis or
death. The clinical evaluation and electromyographic
(EMG) examinations were carried out at 3-month intervals. Results. By applying the AS criteria, the category
of probable or definite diagnosis was achieved in all patients with ALS, except in one (96.6%), as contrary to
the rEE (33.3%), after 6 months of the follow-up period.
The subclinical affection in more than two body regions
has been defined through detection of denervation potentials (80% of the patients by using the AS, or 67% by
the rEE criteria). The complex fasciculations were registered particularly often in small muscles of the feet (37–
40%). Conclusion. Application of the AS criteria improve the achievment of category of probable or definite
diagnosis of ALS by 2.7 months earlier compared to the
rEE. This outcome is particularly affected by a higher frequency of positive EMG findings, when the AS criteria
were employed. Early determination of diagnosis provides
the better perspective and more frequent participation of
the ALS patients in pharmacotherapy studies intended to
establish new therapeutic options.
