Review symptoms and medical history
Perform a neurological examination
Assess muscle strength, tone, reflexes, and coordination
Check for upper and lower motor neuron signs
Order blood and urine tests to rule out other conditions
Perform electromyography (EMG)
Perform nerve conduction studies
Obtain MRI of the brain and spinal cord
Consider lumbar puncture if needed
Evaluate breathing function
Assess speech and swallowing function
Monitor symptom progression over time
Refer to a neurologist, preferably a neuromuscular specialist
Apply established diagnostic criteria such as El Escorial or Awaji criteria