Magnetic resonance tomography of the brain in amyotrophic lateral sclerosis

: We compared the magnetic resonance imaging results of 15 patients suffering from amyotrophic lateral sclerosis (ALS) with those of 30 age-matched controls to search for disease specific cerebral abnormalities. Symmetric hyperintensity along the corticospinal tract on the proton density spin-echo sequence was exclusively found in 4 ALS patients. It was associated with younger age, rapid disease progression and evolution of symptoms starting in the lower extremities. Signal loss of the motor cortex on T2-weighted images was frequently seen in ALS (9 patients) but was also observed in controls. As MRI is capable of providing direct evidence for ALS besides excluding other diseases it should be included in the diagnostic work-up of these patients.