When do you consider CSF testing for patients with suspected ALS?

I have been evaluating and treating ALS (and other motor neuron disease) patients in a tertiary setting for >13 years. CSF testing in my opinion rarely changes the diagnosis, and in typical scenarios with patients showing progressive bulbar onset or limb onset muscle weakness, with combined clinical...

CSF biomarkers (i.e., neurofilament) are being researched and developed. We expect more biomarkers to come to clinical practice over the next few years.

The utility of CSF analysis in ALS rests on excluding mimickers of ALS (i.e., elevated protein in inflammatory motor neuropathies, etc.).

Neurofila...