A middle aged man presents with progressive atrophy & weakness of hand & forearms. On examination he is found to have slight spasticity of the leg, genera-lized hyperreflexia and increased signal in the coico-spinal tracts on T2 weighted MRI. The most likely diagnosis is:
B i.e., Amyotrophic Lateral Sclerosis The presence of both lower motor neuron signs (progressive atrophy & weakness of hands) and upper motor neuron signs (spasticity & hyperreflexia) in the patient with increased signals (hyperintensity) of coicospinal tracts on T2WI of MRIQ leads us to the diagnosis of Amyotrophic lateral sclerosis.
Multiple Sclerosis
Amyotrophic lateral sclerosis
Subacute combined degeneration
Progressive spinal muscular atrophy