Eligibility Criteria:
1. ALS Volunteers
Inclusion Criteria:
* Diagnosis of possible (excluding volunteers with UMN signs ONLY), probable, probable-laboratory supported, or definite ALS, either sporadic or familial according to revised El Escorial criteria
* Disease duration of less than or equal to two years from symptom onset
* Age 30-80 years at the time of disease onset
* Ability to provide informed consent
* Ability to comply with study procedures
* Medically safe to have lumbar puncture (lumbar puncture volunteers only)
Exclusion Criteria:
* Clinical evidence of chronic liver or renal failure
* Presence of a bleeding disorder, problems with CSF pressure, allergy to local anesthetics, or a topical or other skin infection at the LP site (lumbar puncture volunteers only)
* Use of any anti-platelet or anticoagulant drugs, such as plavix, aggrenox, ticlid, warfarin or coumadin (lumbar puncture volunteers only)
2. Suspected ALS (PMND) Volunteers
Inclusion Criteria:
* Diagnosis of suspected ALS defined as presence of UMN or LMN signs alone and the diagnosis of Clinically Probably Laboratory-Supported ALS CANNOT be proven by evidence in clinical grounds in conjunction with electrodiagnostic, neurophysiologic, neuroimaging or clinically laboratory studies
* Disease duration of less than or equal to four years from symptom onset
* Age 30-80 years at time of disease onset
* Ability to provide informed consent
* Ability to comply with study procedures
* Medically safe to have lumbar puncture (lumbar puncture volunteers only)
Exclusion Criteria:
* Clinical evidence of chronic liver or renal failure
* Genetically confirmed diagnosis of hereditary spastic paraparesis or spinal motor atrophy (SMA) disease
* Presence of a bleeding disorder, problems with CSF pressure, allergy to local anesthetics, or a topical or other skin infection at the LP site (lumbar puncture volunteers only)
* Use of any anti-platelet or anticoagulant drugs, such as plavix, aggrenox, ticlid, warfarin or coumadin (lumbar puncture volunteers only)
3. Neurological Disease Mimic Volunteers
Inclusion Criteria:
Diagnosis of one of the following:
Pure Lower Motor Neuron Disease (LMND) mimics:
* Multi-focal motor neuropathy
* Autoimmune motor neuropathy
* Cervical or lumbosacral radiculopathies
Peripheral mononeuropathies:
* Ulnar neuropathy
* Carpal tunnel syndrome/median neuropathy
* Peroneal neuropathy
* Sciatic neuropathy
* Spinal muscular atrophy
* Spinobulbar muscular atrophy (Kennedy's disease)
* Charcot Marie-Tooth Disease (CMT)
Pure Upper Motor Neuron Disease (UMND) mimics:
* Cervical myelopathy
* Multiple sclerosis
* Hereditary spastic paraparesis
* Age 30-80 years
* Ability to provide informed consent
* Ability to comply with study procedures
* Medically safe to have lumbar puncture (lumbar puncture volunteers only)
Exclusion Criteria:
* Diagnosis of suspected, possible, probable or definite ALS either sporadic or familial
* Presence of positive family history of ALS
* Clinical evidence of chronic renal or liver failure
* Presence of a bleeding disorder, problems with CSF pressure, allergy to local anesthetics, or a topical or other skin infection at the LP site (lumbar puncture volunteers only)
* Use of any anti-platelet or anticoagulant drugs, such as plavix, aggrenox, ticlid, warfarin or coumadin (lumbar puncture volunteers only)
4. Healthy Control Volunteers Inclusion Criteria
* Absence of a known neurological disorder.
* Age 30 - 80 years.
* Ability to provide informed consent.
* Ability to comply with study procedures.
* Medically safe to have lumbar puncture.
Exclusion Criteria:
* History of ALS, myopathy, neuropathy, ALS mimic disorder or other neurodegenerative disease.
* Presence of positive family history of ALS.
* Clinical evidence of chronic liver or renal failure.
* Presence of bleeding disorder, problems with CSF pressure, allergy to local anesthetics, or a topical or other skin infection at the LP site (LP research volunteers only).
* Research participant must not be taking anti-platelet or anticoagulant drugs, such as plavix, aggrenox, ticlid, warfarin or coumadin (LP research volunteers only).