Amyotrophic lateral sclerosis (ALS) remains a clinical diagnosis without 
validated biomarkers. To increase diagnostic sensitivity, an expert group 
modified the Airlie House diagnostic criteria and formulated new recommendations 
at a meeting on Awaji Island. Our retrospective analysis of patients referred 
over a 6-month period to the electromyography (EMG) laboratory for suspected 
motor neuron disease (MND) showed a higher agreement of the Awaji modifications 
than the Airlie House criteria with the clinical diagnosis of ALS.