"Bright Tongue" and "Wine Glass" signs in amyotrophic lateral sclerosis

Area of Science:

• Neurology
• Neuroscience
• Medical Imaging

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons.
• Early diagnosis is crucial for patient management and research.
• Understanding characteristic imaging findings aids in differentiating ALS from other neurological conditions.

Purpose of the Study:

• To present a case study of amyotrophic lateral sclerosis (ALS).
• To illustrate classic magnetic resonance imaging (MRI) findings associated with ALS.
• To emphasize the role of neuroimaging in diagnosing motor neuron diseases.

Main Methods:

• A detailed clinical case presentation of a 43-year-old male patient.
• Brain magnetic resonance imaging (MRI) including T2/FLAIR and diffusion-weighted imaging (DWI).
• Electroneuromyography (EMG) for electrophysiological confirmation.

Main Results:

• The patient exhibited progressive symptoms including leg monoparesis, spastic dysarthria, tetraparesis, gait disturbance, muscle atrophy, weakness, and fasciculations.
• Brain MRI revealed characteristic hyperintensities along the corticospinal tracts, including the "bright tongue sign" and "wine glass sign."
• Electroneuromyography confirmed the diagnosis of amyotrophic lateral sclerosis.

Conclusions:

• This case demonstrates the typical clinical progression and classic neuroimaging findings of amyotrophic lateral sclerosis (ALS).
• The "bright tongue sign" and "wine glass sign" on MRI are valuable indicators for ALS diagnosis.
• Integrated clinical, imaging, and electrophysiological data are essential for accurate diagnosis of ALS.