Posted: July 24th, 2017

A 50-year-old man has had gradually progressive weakness of the hands during the past year. Physical examination shows atrophy of the forearm muscles, fasciculations of the muscles of the chest and upper extremities, and hyperreflexia of the lower extremities. A Babinski sign is present bilaterally. Sensation is intact. Which of the following is the most likely diagnosis?

A 50-year-old man has had gradually progressive
weakness of the hands during the past year.
Physical examination shows atrophy of the
forearm muscles, fasciculations of the muscles of
the chest and upper extremities, and
hyperreflexia of the lower extremities. A
Babinski sign is present bilaterally. Sensation is
intact. Which of the following is the most likely
diagnosis?
(A) Amyotrophic lateral sclerosis
(B) Dementia, Alzheimer type
(C) Guillain-Barré syndrome
(D) Multiple cerebral infarcts
(E) Multiple sclerosis