Clinical features of amyotrophic lateral sclerosis
There are different clinical features in amyotrophic lateral sclerosis for the upper and lower limbs:
Lower limbs:
- lower motor neurone lesions develop at a late stage so that for much of the time, the presentation is that of an uncomplicated picture of corticospinal tract degeneration. Weakness and spasticity are the major features but they are rarely severe.
Upper limbs:
- upper and lower motor neurone signs are evident causing weakness much greater than suggested by the degree of wasting.
- reflexes may be impaired or exaggerated depending upon whether the LMN or UMN degeneration is greatest.
- consequently, exaggerated reflexes may occur in the presence of severe wasting - a unique picture
Reference
- van Es MA, Hardiman O, Chio A, et al. Amyotrophic lateral sclerosis. Lancet. 2017 Nov 4;390(10107):2084-98.
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