In most cases, ALS is not hereditary. The majority of ALS cases occur sporadically, meaning they have no clear family history of the disease. However, approximately 5-10% of ALS cases are considered familial, where there is a genetic component. Mutations in certain genes, such as C9orf72, SOD1, and others, have been linked to familial ALS. Individuals with a family history of ALS may have a higher risk of developing the disease, but the overall risk is still relatively low. Genetic counseling can help assess the risk of inheriting ALS in families with a history of the disease.