Presentation
Progressive motor weakness since 14 months initially started as difficulty in walking and weakness in limbs followed by unable to walk, increase in severity since last 3 months, bedridden at present with unremarkable birth history.
Patient Data
Symmetrical T2/FLAIR hyperintensity involving bilateral precentral gyrus, corona radiata, posterior limb of the internal capsule, cerebral peduncle, and brainstem showing no restriction on DWI/ADC. On SWI, there is no drop in signal intensity in the precentral gyrus.
T2/FLAIR white matter hyperintensity was also noted involving bilateral peritrigonal white matter.
Case Discussion
T2/FLAIR hyperintensity involving the corticospinal tract with progressive motor weakness involving both upper and lower motor neurons is consistent with amyotrophic lateral sclerosis. Sometimes, T2/SWI dark band is noted in the precentral gyrus but this feature is not seen in our case.
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