Abstract
Amyotrophic lateral sclerosis was found to be unusually prevalent on the island of Guam. 35 cases, representing an incidence of 13 per 10,000 native inhabitants, were examined and summaries of 16 other cases were compiled. Unusual aspects of the series include an unusually high familial incidence (40%), a higher incidence of spasm or rigidity, an extremely large number of cases (80%) exhibiting signs of pseudobulbar palsy, and involvement of the spinal accessory nerve in 40%.

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