Amyotrophic lateral sclerosis is a progressive disease of the motor neurons, the nerve cells that carry movement commands from the brain to the muscles. Both the upper and the lower motor neurons degenerate, producing a combination of weakness and wasting with stiffness and brisk reflexes that is characteristic of the condition. Sensation, and usually thinking, are spared, though a minority develop frontotemporal changes.
Amyotrophic lateral sclerosis is a progressive disease of the motor neurons, the nerve cells that carry movement commands from the brain to the muscles. Both the upper and the lower motor neurons degenerate, producing a combination of weakness and wasting with stiffness and brisk reflexes that is characteristic of the condition. Sensation, and usually thinking, are spared, though a minority develop frontotemporal changes.
Onset is usually focal and asymmetric, which is why it is so often mistaken for something local at first. It may be a weak hand that drops things or cannot manage buttons, a foot that catches on kerbs, or slurred speech and difficulty swallowing when the bulbar muscles are affected first. Muscle twitching, visible rippling under the skin and cramps are common. Weight loss and shortness of breath on lying flat come later and are important, because respiratory involvement drives the prognosis more than limb weakness does.
There is no single blood test for this diagnosis. It is made clinically and supported by EMG and nerve conduction studies, which demonstrate the loss of motor nerve supply to muscles across different regions of the body while sensory studies remain normal. That pattern is what separates it from the conditions that mimic it, several of which are treatable: multifocal motor neuropathy, cervical myelopathy, myasthenia gravis, inclusion body myositis. Both offices operate AANEM-accredited electrodiagnostic laboratories, and the neurologist who orders the study performs and interprets it. MRI and blood work are used to exclude the mimics; imaging is arranged elsewhere.
A small number of drugs are approved to slow progression, riluzole among them, and the list changes as trials report, so it should be checked against a current source rather than an article. Genetic testing matters for a minority, because a specific treatment exists for one inherited form and trial eligibility often depends on genetics. Everything else is about function and comfort: swallowing and nutrition, breathing support, communication aids, mobility equipment, spasticity, saliva management and cramps. There is no cure at present, and being told that early is more useful than discovering it after a year of searching.
Multidisciplinary ALS clinics, which bring neurology, pulmonology, nutrition, physical and occupational therapy, speech therapy and social work into one visit, are the recognised standard, and this practice is not one. What happens here is the diagnostic work, including the electrodiagnostic studies, and referral into that kind of programme, alongside general adult neurology follow-up. Being clear about that division is more useful to patients than implying a service that does not exist.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.