Sensory Involvement in ALS

Diagnostic Considerations

• Electromyography (EMG) detects abnormalities in sensory nerve conduction, which can aid in the diagnosis of ALS, particularly in patients with prominent sensory symptoms 1
• Actively screening for and identifying sensory neuropathy can improve patient management by explaining sensory symptoms, allowing targeted symptomatic treatment, and preventing unnecessary diagnostic workup for alternative conditions 2

Clinical Approach

• When evaluating suspected ALS, a thorough sensory examination including light touch, pinprick, vibration, and proprioception should be performed, and nerve conduction studies should be considered if sensory symptoms are prominent 1
• The American College of Radiology recommends considering nerve conduction studies in patients with suspected ALS and prominent sensory symptoms, as it can help detect abnormalities in sensory nerve conduction 3

Differential Diagnosis

• Prominent early sensory symptoms with minimal motor involvement should prompt consideration of alternative diagnoses, such as Guillain-Barré syndrome variants or other peripheral neuropathies, as recommended by the National Institute of Neurological Disorders and Stroke, and supported by research published in Nature Reviews Neurology 4, 2