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Neurology · NEET PG Preparation Medicine

A 62-year-old man presents with progressive weakness and muscle wasting in his right hand for the past 4 months, followed by similar involvement of t…

Practice question from Neurology (NEET PG Preparation Medicine), with the correct answer and a step-by-step solution.

medium · MCQ · Q-47D8E3

A 62-year-old man presents with progressive weakness and muscle wasting in his right hand for the past 4 months, followed by similar involvement of the left hand and both legs. On examination, he has fasciculations and muscle atrophy in the upper limbs, along with hyperreflexia, upgoing plantars, and a spastic gait. Cranial nerve examination is completely normal, and there are no sensory deficits. What is the most likely diagnosis?

  1. A.Amyotrophic lateral sclerosisCorrect answer
  2. B.Primary lateral sclerosis
  3. C.Progressive muscular atrophy
  4. D.Cervical spondylotic myelopathy

Solution

Amyotrophic lateral sclerosis (ALS) is characterized by the degeneration of both upper motor neurons (UMN) and lower motor neurons (LMN). Clinical features include a combination of LMN signs in the limbs (weakness, wasting, fasciculations) and UMN signs (hyperreflexia, spasticity, extensor plantar responses), with normal sensory and ocular motor functions.

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