So my presentation focused on ALS, mimics and chameleons and I talked about the diagnostic challenges of the disease. ALS is still a disease of exclusion. We still do not have a very specific biomarker or any specific MRI changes which can give us a final diagnosis. It’s a clinical diagnosis. We use a clinical criteria to diagnose someone but meanwhile we should not miss very treatable diseases for example ALS can have very different types of mimics for example chronic inflammatory demyelinating polyradiculoneuropathy in short CIDP can mimic it...
So my presentation focused on ALS, mimics and chameleons and I talked about the diagnostic challenges of the disease. ALS is still a disease of exclusion. We still do not have a very specific biomarker or any specific MRI changes which can give us a final diagnosis. It’s a clinical diagnosis. We use a clinical criteria to diagnose someone but meanwhile we should not miss very treatable diseases for example ALS can have very different types of mimics for example chronic inflammatory demyelinating polyradiculoneuropathy in short CIDP can mimic it. Neuromuscular diseases as well, myasthenia can mimic ALS. Also, the multifocal motor neuropathy, this is what I emphasized during the presentation, that we should not miss the treatable diseases, which at first can definitely look like ALS. And also I focused on the fact that it’s not a very classic disorder so sometimes it can begin in an untraditional way and it can start with for example bulbar symptoms it can start with upper motor neuron damage symptoms and or it could be dementia the first clue of having ALS so also this is a type of chameleon in ALS where you do not initially see that it’s the classical ALS but usually what happens is that it sprouts into a classic disease later on during the years. Through these years of my experience giving the diagnosis of ALS, it has not been easier with the years. It’s still challenging for us clinicians and especially for the patients because even though we are a bit progressing towards genetic forms of ALS, the treatment is there. For example, we have tofersen available. This is a very small percentage of patients who can benefit from it. And the disease is fatal. It’s neurodegenerative. We do not have a very nice drug which can halt the disease. So still the challenges are there. How we give the diagnosis, it’s a second question that we should spend more time with the patient. It was also emphasized during our presentation. And these challenges are still there. Hopefully we will be able to spend more time with the patient during the diagnosis, more time giving the diagnosis as well, and being with the patient during these challenging years is, of course, what we are looking for. And we are going through this fight every day with the patient. And yes, I think it’s a very challenging disease nowadays.
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