Amyotrophic lateral sclerosis is a neurodegenerative disorder affecting upper and lower motor neurons in primary motor cortex, brainstem and spinal cord. We present a case of a 24-year-old young male who presented with progressive quadriparesis and bulbar palsy with MRI brain revealing characteristic hyperintensities of the corticospinal tracts bilaterally, extending from the internal capsule to the brainstem, producing a 'wine glass' appearance on coronal sections.