A patient reports difficulty with holding eating utensils and writing but denies difficulty when using the left hand.Upon physical examination,fasciculations and a positive Babinski sign are noted in the right upper extremity.Which of the following is the MOST likely diagnosis?

Question

Quizplus · Accepted Answer

The symptoms of difficulty with holding utensils and writing, along with fasciculations and a positive Babinski sign in only one upper extremity, suggest a diagnosis of amyotrophic lateral sclerosis (ALS). ALS is a progressive neurodegenerative disease that affects both upper and lower motor neurons, leading to muscle weakness and atrophy. Fasciculations and positive Babinski sign are specific findings in ALS. Acute poliomyelitis, Guillain-Barré syndrome, and Charcot-Marie-Tooth disease can also present with muscle weakness but are less likely to cause fasciculations and positive Babinski sign in only one upper extremity.

A Patient Reports Difficulty with Holding Eating Utensils and Writing