Sir,We thank you for the appreciation of out paper “Clinical mimickers of amyotrophic lateral sclerosis-conditions we cannot afford to miss.” In this discussion, you have managed to bring our two very interesting entities which can mimic an anterior horn cell pathology.Lyme disease presenting as multiple radiculopathy is a very challenging but rewarding diagnosis to make in patients with rapidly progressive weakness involving cranial nerves and/or peripheral nerves, with or without cord involvement. I think the presence of a rash and pain as two initial symptoms can be a good clue to the detection of this treatable condition.It was also interesting to note the role of eosinophilic fasciitis, but during active disease, the local symptoms can clearly demarcate the lesion. However, residual contracture can be a confounding factor in patients with healed eosinophilic fasciitis and this condition can be kept as a differential of anterior horn cell localization.