How to improve the diagnostic process.

The existing therapeutic options for treating amyotrophic lateral sclerosis (ALS) are relatively limited but, as therapies improve, there will be a need for early diagnosis of this rare but fatal neurogenerative disorder. Early diagnosis not only requires the utility of a good biological marker, it also requires medical personnel who are experienced to consider/establish a diagnosis of ALS. In many countries, diagnosis of ALS follows a three-step process involving the family physician/practitioners, a community neurologist and an ALS specialist. This process is cumbersome and as the number of cases seen by the first two doctors is extremely small, their awareness is consequently low. There is an urgent need to improve the awareness of ALS in the family physicians but also within the general population. A number of elements which probably contribute to delays in achieving an early diagnosis of ALS will be discussed in this paper with the view of identifying how the diagnostic process can be improved.