]> 2026-07-31T07:51:17+00:00 WBR0576 0 en This image typically depicts spinal cord lesions consistent with ALS. ALS may involve both the descending corticospinal tracts (upper motor neurons) and the anterior horns (lower motor neurons). The involvement of both the upper and lower motor neuron pathways is the hallmark of ALS. Pathophysiology A 55-year-old woman with poor medical follow-up presents with ulcers on the soles of her feet. Upon questioning, the patient reports lower extremity numbness and imbalance for the past 3 months. She also complains of occasional urinary incontinence and shooting pains in her abdomen and back, which she sometimes attributed to indigestion. On physical examination, the physician notices bilateral miotic pupils that are non-reactive to light but are reactive to accomodation. He also notes the presence of foot ulcers, diminished reflexes in the lower extremities, and a wide-based, slapping gait. Which of the following images depict the spinal cord lesions that are most likely responsible for the patient's condition (lesion in red)? A Neurology 2020-10-28T01:01:23Z 2459150.5426273 WBR0576