Presentation
Progressive muscle weakness through the last 2 years
Patient Data
High signal intensity involves the precentral gyri and descends through the corticospinal tracts in the posterior aspects of internal capsule and brainstem. It elicits high signal at T2 , FLAIR WI & specifically highlighted on DWI.
Case Discussion
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.
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