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The lecture will summarize the electrodiagnostic changes in ALS and how they are explained regarding its pathogenesis. This topic will permit us to address the diagnostic guidelines, including historical changes and the updated version. Information about testing its sensitivity and specificity will be shared. A number of real cases will be introduced to discuss diagnosis in order to stress limitations and difficulties, discussing mimicking disorders. Finally, additional relevant information from specific neurophysiological observations will be stressed to increment the utility of routine EMG. Conclusions remarks will finish the lecture.