Diagnosis confirmed by EMG & NVC.

Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease.

The earliest MR manifestation is hyper intensity on T2WI in the corticospinal tracts, seen earliest in the internal capsule.

Diffusion-weighted imaging is also helpful in the diagnosis of amyotrophic lateral sclerosis

Iron deposition in the cortex is demonstrated as loss of signal, most evident on T2* weighted sequences.