National Physical Therapy Examination (NPTE) Practice Exam

Based on neuro impairments including dysarthria and motor weakness, which condition is most likely represented when hyperreflexia is also present?

1. Cervical myelopathy

2. Myasthenia gravis

3. Amyotrophic lateral sclerosis

4. Multiple sclerosis

The correct answer is: Amyotrophic lateral sclerosis

The presence of hyperreflexia combined with dysarthria and motor weakness suggests a condition that affects the upper motor neurons. In the case of amyotrophic lateral sclerosis (ALS), there is both upper and lower motor neuron involvement. Dysarthria, characterized by difficulty in articulating words, can be attributed to weakness in the muscles responsible for speech, which might stem from damage in the motor neurons controlling these muscles. Hyperreflexia is a hallmark sign of upper motor neuron lesions. Since ALS progressively affects both types of motor neurons, the combination of motor weakness and hyperreflexia becomes very characteristic of this condition. In individuals with ALS, one would observe both increased muscle tone and exaggerated reflexes due to the upper motor neuron dysfunction, along with the noted dysarthria resulting from bulbar involvement. While other conditions listed may also cause similar symptoms, ALS is uniquely associated with the combination of both upper and lower motor neuron signs, indicating the presence of hyperreflexia alongside dysarthria and motor weakness.