Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by degeneration of motor neurons, with the tongue often involved in clinical presentation. In this case, a 60-year-old female presented with progressive choking episodes and speech slurring over 9 months, exhibiti...

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Main Authors: Seid Mohammed Shobe, Dereje Melka, Mesfin Mulugeta, Leul Adane
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325004790
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author Seid Mohammed Shobe
Dereje Melka
Mesfin Mulugeta
Leul Adane
author_facet Seid Mohammed Shobe
Dereje Melka
Mesfin Mulugeta
Leul Adane
author_sort Seid Mohammed Shobe
collection DOAJ
description Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by degeneration of motor neurons, with the tongue often involved in clinical presentation. In this case, a 60-year-old female presented with progressive choking episodes and speech slurring over 9 months, exhibiting dysarthria, prominent tongue atrophy, fasciculations, and hyperreflexia. Needle electromyography (EMG) showed diffuse chronic neurogenic changes with signs of active denervation changes prominent on the tongue and right arm with normal sensory nerve studies. Magnetic resonance imaging (MRI) brain imaging revealed a Diffuse T1 Weighted image (T1WI) hyperintense of tongue known as ''bright tongue sign'' indicating fatty infiltration of tongue muscles, consistent with neurogenic atrophy. This case underscores the importance of recognizing this characteristic tongue hyperintensity as a valuable radiological clue in diagnosing bulbar-onset ALS and highlights the potential for early diagnosis to improve patient management and outcomes
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institution Kabale University
issn 1930-0433
language English
publishDate 2025-09-01
publisher Elsevier
record_format Article
series Radiology Case Reports
spelling doaj-art-2fbe62a31faa40fa80964168fd46d1162025-08-20T03:50:22ZengElsevierRadiology Case Reports1930-04332025-09-012094338434110.1016/j.radcr.2025.05.044Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case reportSeid Mohammed Shobe0Dereje Melka1Mesfin Mulugeta2Leul Adane3Department of Radiology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia; Corresponding author.Department of Neurology, Addis Ababa University School of Medicine, Addis Ababa, EthiopiaDepartment of Radiology, Addis Ababa University School of Medicine, Addis Ababa, EthiopiaDepartment of Radiology, Addis Ababa University School of Medicine, Addis Ababa, EthiopiaAmyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by degeneration of motor neurons, with the tongue often involved in clinical presentation. In this case, a 60-year-old female presented with progressive choking episodes and speech slurring over 9 months, exhibiting dysarthria, prominent tongue atrophy, fasciculations, and hyperreflexia. Needle electromyography (EMG) showed diffuse chronic neurogenic changes with signs of active denervation changes prominent on the tongue and right arm with normal sensory nerve studies. Magnetic resonance imaging (MRI) brain imaging revealed a Diffuse T1 Weighted image (T1WI) hyperintense of tongue known as ''bright tongue sign'' indicating fatty infiltration of tongue muscles, consistent with neurogenic atrophy. This case underscores the importance of recognizing this characteristic tongue hyperintensity as a valuable radiological clue in diagnosing bulbar-onset ALS and highlights the potential for early diagnosis to improve patient management and outcomeshttp://www.sciencedirect.com/science/article/pii/S1930043325004790Bright tongue signCase reportMRI
spellingShingle Seid Mohammed Shobe
Dereje Melka
Mesfin Mulugeta
Leul Adane
Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report
Radiology Case Reports
Bright tongue sign
Case report
MRI
title Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report
title_full Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report
title_fullStr Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report
title_full_unstemmed Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report
title_short Bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis: A case report
title_sort bright tongue sign as a radiological clue of bulbar onset amyotrophic lateral sclerosis a case report
topic Bright tongue sign
Case report
MRI
url http://www.sciencedirect.com/science/article/pii/S1930043325004790
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