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 Q32 - A 50-year-old man has had gradually  

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A 50-year-old man has had gradually progressive
weakness of the hands over the past year. Examination
shows atrophy of the forearm muscles,
fasciculations of the muscles of the chest and upper
limbs, hyperreflexia of the lower limbs, and extensor
plantar reflexes. Sensation is intact. Which of the
following is the most likely diagnosis?
(A) Amyotrophic lateral sclerosis
(B) Dementia, Alzheimer's type
(C) Guillain-Barré syndrome
(D) Multiple cerebral infarcts
(E) Multiple sclerosis


a classic presentation... ALS


Correct !!


ALS (UMN and LMN in lower and upper limbs)


atrophy --->LMN

fasciculations hyperreflexia --->UMN



fasciculation are part of LMN

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