We present a case of amyotrophic lateral sclerosis (ALS) in middle-aged woman who presented with 2-year history dysarthria and dysphagia. On examination, she had spastic dysarthria, jaw clonus (video 1), hyperreflexia, fasciculations involving the tongue, trunk, extremities. Jaw is an upper motor sign that localizes to dysfunction corticobulbar fibers cranial 5th nerve nucleus. It analogous ank...