<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 62-year-old woman is brought to the physician because of 6 months of progressive weakness in her arms and legs. During this time, she has also had difficulty swallowing and holding her head up. Examination shows pooling of oral secretions. Muscle strength and tone are decreased in the upper extremities. Deep tendon reflexes are 1 in the right upper and lower extremities, 3 in the left upper extremity, and 4 in the left lower extremity. Sensation to light touch, pinprick, and vibration are intact. Which of the following is the most likely diagnosis?? A: Amyotrophic lateral sclerosis, B: Guillain-Barré syndrome, C: Syringomyelia, D: Myasthenia gravis, E: Spinal muscular atrophy,  <response>: Based on the information provided in the question stem, the key findings are:- Progressive weakness in arms and legs over 6 months - Difficulty swallowing and holding head up- Decreased muscle strength and tone in upper extremities- Asymmetric reflexes reduced on right side, increased on left side- Intact sensation This points towards an upper motor neuron disease like amyotrophic lateral sclerosis ALS, rather than a peripheral neuropathy or myopathy. ALS classically presents with asymmetric reflexes due to the mixed upper and lower motor neuron involvement. The bulbar symptoms swallowing, speech also fit with ALS.A: Amyotrophic lateral sclerosis 