MRCP2-3246
A 63-year-old man is experiencing difficulty walking. He has a medical history of diabetes mellitus and cervical spondylosis, for which he underwent surgical decompression eight years ago. Additionally, he consumes 40 units of alcohol per week.
During examination, the patient exhibited fasciculation, wasting, and weakness in the left deltoid and biceps, as well as weakness in the shoulder girdle muscles on both sides. There was also fasciculation in the glutei and quadriceps bilaterally, weakness in hip flexion and foot dorsiflexion, brisk reflexes in the upper and lower limbs, and extensor plantar responses. No sensory impairment was detected.
What is the likely diagnosis for this patient?