Presentation
Slightly progressive strength loss and atrophy of the right upper extremity.
Patient Data
Symmetric hyperintensity of corticospinal tracts along its intracranial path including centrum semiovale, internal capsule, cerebral peduncles and ventral brain stems on T2 and FLAIR secuences.
Bilateral hypointensity in precentral gyrus on SWI and FLAIR secuences due to the iron deposition in the cortex.
Bilateral symmetric continuous hyperintensity of the spinal lateral segments, affecting to the pyramidal tract, extending from craniospinal junction to C6 level.
Incidental finding of isolated milimetric microbleed in left frontal subcortical white matter.
Findings are consistent with first motor neuron disease.
Case Discussion
MRI findings consistent with first motor neuron disease and electrophysiological evidence of diffuse spinal motor neuron degeneration give the diagnosis of amyotrophic lateral sclerosis.
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