36yo Woman with Progressi...

A 36-year-old woman presents with progressive right upper limb weakness, altered sensations, and hyperhidrosis in both palms. Neurological examination reveals muscle atrophy, increased tone, and tremors in the right upper limb, clonus in the left calf, and a positive Babinski sign. MRI shows uncertain atrophy-like changes in the cervical spine. Investigations confirm upper and lower motor neuron lesions.