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The Awaji criteria proposed in 2008 re-evaluated electrophysiological findings and emphasized the diagnostic significance of fasciculation potentials (FPs) in amyotrophic lateral sclerosis (ALS). FPs were regarded to be equivalent to denervation potentials (fib-psw) in terms of clinical significance. The implication is that FPs are closely related to the progressive denervation process of muscles in ALS. The characteristic features of FP in ALS are complexity and instability. Complex FPs (CFPs) are thought to originate in distal axonal sprouts, associated with the reinnervation process. These differ from FPs observed in other pathological states, which are thought to originate from anterior horn or nerve root. CFPs may be useful for early diagnosis of ALS patients and should be evaluated in the EMG examination.

Fasciculation potentials in ALS—significance, and relationship with clinical features