Amyotrophic Lateral Sclerosis (ALS) – Symptoms, Diagnosis, and EMG Testing

Overview

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, is a progressive neurological condition that affects the nerve cells (motor neurons) in the brain and spinal cord. These neurons control voluntary muscle movement—such as walking, talking, eating, and breathing. Over time, ALS causes these motor neurons to deteriorate and die, leading to muscle weakness, stiffness, and loss of control.

At California Sports and Rehab, Dr. Hakimian and our team use electrodiagnostic testing (EMG and NCV) to help confirm or rule out ALS and other neuromuscular conditions. Although there is currently no cure, early diagnosis and supportive care can help slow progression and improve quality of life.

Common Symptoms of ALS

ALS symptoms vary from person to person, but they generally begin gradually and worsen over time.
Early signs may include:

  • Muscle weakness in the arms, legs, or hands
  • Difficulty with fine motor skills such as buttoning a shirt or writing
  • Muscle cramps, stiffness, or twitching (fasciculations)
  • Slurred speech or trouble swallowing
  • Fatigue and loss of coordination
  • Emotional changes, such as inappropriate laughing or crying

As ALS progresses, it may affect breathing, speech, and mobility. Sensation (touch, taste, smell, and vision) typically remains normal.

Causes and Risk Factors

In about 90% of cases, ALS develops sporadically, meaning without a clear inherited cause. The remaining 10% are familial (genetic) forms passed down through families.

Current research suggests ALS may result from a combination of genetic and environmental factors, such as:

  • Family history of ALS
  • Older age (most common between 55 and 75 years old)
  • Male sex (slightly higher risk before age 65)
  • Smoking
  • Exposure to toxins or heavy metals
  • Military service (due to environmental exposures or physical trauma)

How ALS Is Diagnosed

There is no single test that confirms ALS. Instead, diagnosis relies on a combination of clinical evaluation and specialized studies that assess nerve and muscle function.

At California Sports and Rehab, Dr. Hakimian performs detailed neurological and electrodiagnostic evaluations, including:

  • Electromyography (EMG): Measures electrical activity in muscles to detect abnormal patterns caused by nerve damage.
  • Nerve Conduction Velocity (NCV) studies: Assess how well nerves transmit electrical signals.
  • Imaging (MRI): Used to rule out other brain or spinal cord conditions.
  • Laboratory and genetic tests: Help exclude other causes of neuromuscular weakness.

These tests are essential for distinguishing ALS from other treatable neuromuscular conditions.

nerve test

Treatment and Management

While there’s currently no cure for ALS, several treatment approaches can slow progression and improve comfort:

  • Medications: FDA-approved drugs like Riluzole and Edaravone may extend survival and slow functional decline.
  • Physical and occupational therapy: Help maintain strength and mobility.
  • Speech therapy: Supports communication and swallowing.
  • Nutritional support: Ensures adequate intake despite swallowing difficulties.
  • Respiratory therapy: Provides breathing assistance as muscles weaken.

At our clinic, we collaborate with patients and their care teams to monitor disease progression and recommend evidence-based interventions.

Electrodiagnostic Testing (EMG and NCV) for ALS

EMG and NCV studies are key tools in the early detection of ALS and other motor neuron diseases. These tests help your neurologist:

  • Identify whether muscle weakness originates from the nerve, spinal cord, or muscle itself
  • Distinguish ALS from neuropathies, myopathies, or nerve compression
  • Guide treatment planning and follow-up evaluations

If you are experiencing unexplained muscle weakness or twitching, scheduling an EMG test can be an important first step toward diagnosis.

When to See a Nerve Specialist

You should seek evaluation from a nerve specialist or neurologist such as Dr. Hakimian if you notice:

  • Persistent or worsening muscle weakness
  • Unexplained twitching or cramping
  • Difficulty swallowing or speaking
  • Fatigue that affects daily activities

Early testing helps rule out other conditions and allows for faster treatment planning.

Frequently Asked Questions (FAQ)

Q: What is the difference between ALS and other nerve disorders?
A: ALS specifically affects motor neurons, leading to progressive muscle weakness. Other disorders, such as peripheral neuropathy, affect sensory or mixed nerves and often have treatable causes.

 A: EMG can’t diagnose ALS on its own, but it provides critical information showing motor neuron damage. Combined with clinical findings, it helps confirm the diagnosis and rule out other diseases.

 A: About 10% of cases are inherited. Genetic testing can determine if there’s a familial mutation involved.

 A: There’s currently no cure, and no proven way to prevent ALS. However, ongoing research and emerging therapies are showing promise in slowing disease progression.

 A: Our clinic provides state-of-the-art EMG and NCV testing for early and accurate diagnosis of neuromuscular conditions, including ALS. Dr. Hakimian works closely with your care team to ensure comprehensive, compassionate management.

Schedule an EMG or NCV Test

If you or a loved one are experiencing symptoms of muscle weakness, twitching, or speech changes, contact California Sports and Rehab to schedule an EMG test near you.
Early evaluation can make a meaningful difference in care and quality of life.

📞 Call 310-652-6060
📍 Serving patients throughout California — trusted by patients searching for a nerve doctor or nerve specialist near me.

Request Your Appointment

We accept most insurances, Private, Worker’s Comp and Personal Injury.