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A Comparison of Guam and Classical Cases

Asao Hirano, MD; N. Arumugasamy, MD; H. M. Zimmerman, MD

Arch Neurol. 1967;16(4):357-363.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Amyotrophic lateral sclerosis (ALS), a disease well known for almost 100 years, occurs throughout the world. Approximately 15 years ago, an unusually high incidence of ALS was noted among the indigenous Chamorro population on Guam of the Mariana Islands. Subsequently, detailed epidemiological, clinical, and pathological studies confirmed the fact that the condition on Guam fulfilled the classical criteria of ALS. However, three major unusual features were noted in these studies: (1) an extraordinarily high incidence, often with familial aggregation^1,2; (2) the development, in some instances, of clinical evidence of dementia and extrapyramidal symptomatology³; (3) the presence of histological changes characteristic of the parkinsonismdementia complex (PD), another endemic fatal neurological disease affecting the Chamorros on Guam.^4,5 These features were not previously recognized among classical ALS cases. In addition, two clinical features which are not notable among classical ALS cases were discovered as a result of several investigations, including . . . [Full Text PDF of this Article]

Author Affiliations
New York

From the Henry and Lucy Moses Research Laboratories of the Laboratory Division, Montefiore Hospital and Medical Center, Bronx, New York. Dr. Arumugasamy is from the Ministry of Health, Malaysia. He is a resident in neurosurgery, Wesley Memorial Hospital, Chicago, assigned to the Neuropathology Department, Laboratory Division, Montefiore Hospital and Medical Center.

Footnotes
Submitted for publication Dec 7, 1966; accepted Dec 9.

Reprint requests to Montefiore Hospital, 111 E 210th St, Bronx, New York 10467 (Dr. Zimmerman).

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