Awaji-shima consensus criteria for clinical classification of amyotrophic lateral sclerosis (de Carvalho et al. 2008) A. Diagnosis of amyotrophic lateral sclerosis requires the following characteristics: 1. clinical, electrophysiological, or neuropathological examination confirms the presence of lower motor neuron degeneration; 2. clinical examination confirms the presence of upper motor neuron degeneration; 3. history or examination confirms progressive worsening of symptoms or signs, which may be limited to a single site or may extend from one 3. History or examination confirms that the progression of symptoms or signs can be limited to a single site or extend from one site to other sites. B. Except in the following cases: 1. electrophysiological or pathological examination reveals the presence of other diseases that can cause upper or lower motor neuron degeneration; 2. neuroimaging reveals the presence of other diseases that can cause clinical and electrophysiological abnormalities. Definite clinical ALS: clinical or electrophysiological evidence supports the presence of both upper and lower motor neuron lesions, including the medulla oblongata and at least two spinal cord sites, or lesions in three spinal cord sites; probable clinical ALS: clinical or electrophysiological evidence supports the presence of both upper and lower motor neuron lesions, including at least two sites, and Some upper motor neuron damage is higher than lower motor neuron damage; clinically probable ALS: clinical or electrophysiologic evidence supports the presence of both upper and lower motor neuron lesions, but only at 1 site, or upper motor neuron lesions only, involving more than 2 sites, or lower motor neuron damage is higher than upper motor neuron damage.