Role of PET and SPECT in the Study of Amyotrophic Lateral Sclerosis

Table 1

ALS diagnostic categories according to the El Escorial World Federation of Neurology diagnostic criteria.

Clinically definite ALS	Defined on clinical evidence alone by the presence of UMN, as well as LMN signs, in three regions
Clinically probable ALS	Defined on clinical evidence alone by UMN and LMN signs in at least two regions with some UMN signs necessarily rostral to (above) the LMN signs.
Clinically probable-laboratory-supported ALS	Defined when clinical signs of UMN and LMN dysfunction are in only one region, or when UMN signs alone are present in one region, and LMN signs defined by EMG criteria are present in at least two limbs, with proper application of neuroimaging and clinical laboratory protocols to exclude other causes.
Clinically possible ALS	Defined when clinical signs of UMN and LMN dysfunction are found together in only one region or UMN signs are found alone in two or more regions; or LMN signs are found rostral to UMN signs and the diagnosis of clinically probable-laboratory-supported ALS cannot be proven by evidence on clinical grounds in conjunction with electrodiagnostic, neurophysiologic, neuroimaging, or clinical laboratory studies. Other diagnoses must have been excluded to accept a diagnosis of clinically possible ALS