MND-ALS EL ESCORIAL CRITERIA

SUMMARY

Updated El Escorial criteria (2015):

1. Progressive UMN & LMN symptoms & signs in one limb or body segment.
2. Clinical LMN signs in one segment or EMG signs in two or more segments.

NOTE
3. In this context, electrodiagnostic findings may manifest as either the chronic changes of neurogenic potentials or the acute changes of fibrillations or positive sharp waves.
4. EMG findings: abnormal insertional activity, delayed recruitment, long duration & large amplitude motor unit action potentials, complex repetitive discharge (neuropathic pattern).
5. There must be absence of any other confounding pathology.
6. There must be continued progression of disease.

7. NCS is used to exclude NMJ and other axonal/demyelinating diseases. SNAP & CMAP are normal.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].