ALS is a clinical diagnosis. Due to the absence of any disease bio-markers, the presence of both UMN and LMN signs and symptoms in the same body region along with the progression of these symptoms. Modified El-Escorial<unk>  criteria are used for elucidation of electrophysiological changes for the diagnosis of ALS. El- Escorial criteria are also known as Airlie House recommendations. It was revised in a meeting at Awaji Island, Japan in 2006. Current Airlie house recommendations were revised step by step. Awaji criteria have a significant impact on the early diagnosis of ALS. Currently, Gold coast criteria are used for the diagnosis of ALS.
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