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Is PMA a “real” ALS?

For a long time, it was disputed whether progressive muscular atrophy (PMA) was a separate disease from ALS. It is now known that ALS can be limited to the second motor neuron and that PMA represents a specific variant of ALS. Typical ALS and PMA share a common clinical course (progressive paralysis) and a common mechanism of disease (harmful protein deposition in motor neurons).