Hector R. Martínez, School of Medicine and Health Sciences, Tecnológico de Monterrey, Monterrey; Neurology and Neurosurgery Institute, Hospital Zambrano Hellion, TecSalud, San Pedro Garza García, México

Amyotrophic lateral sclerosis (ALS) is a chronic neurodegenerative disorder characterized by upper and lower motor neurons death, the diagnosis remains in clinical basis. Clinical criteria El Escorial for its diagnosis were published in 1994, the revised criteria in 2000 and modified by the Awaji criteria in 2008 to integrate electrophysiological data with the clinical examination. These criteria are complex to apply and have difficulties to determine progression through ALS categories. Recent advances in genetics, biomarkers such as light chain neurofilament (NfL), cytokines, neuroimaging, and neurophysiological probes of upper motor neuron dysfunction are not included in the diagnostic criteria. In 2019, new and simple ALS diagnostic criteria (Gold Coast criteria) have been introduced along with genetic testing and serum and cerebrospinal fluid NfL levels. Early diagnosis for initiating disease-modifying drugs and care in a multidisciplinary ALS clinic will improve quality of life and survival in ALS patients. In this article, I consider that it is an urgency to facilitate an early recognition of possible ALS among primary care physicians as well as to foster of urgency among neurologist to accelerate the diagnostic process of ALS to protect viable motor neurons and slow down the process of neurodegeneration.

Keywords: Amyotrophic lateral sclerosis. Gold Coast criteria. Biomarkers. Riluzole. Edaravone. Relyvrio.