Amyotrophic Lateral Sclerosis/Parkinsonism-Dementia Complex of Guam: Two Distinct Clinical Entities or a Single Disease Process with a Spectrum of Neuropathological and Clinical Expression?
Guam is the largest of the Marianas islands, an archipelago in the western pacific that lies approximately 3800 miles west of Hawaii and 1500 miles south of Tokyo. Guam has a total land area of 225 square miles and measures approximately 30 miles long and 4 to 9 miles wide. Of the total civilian population of 110,000, approximately 55,000 of the island’s inhabitants are an indigenous native people referred to as Chamorros, with 25,000 inhabitants being migrants from the Philippines while an additional 20,000 inhabitants originate from other ethnic backgrounds (predominantly Caucasian, Carolinian, Hawaiian, and other Asian immigrants). Finally, there are several large military bases on the island with approximately 25,000 military personnel and dependents assigned to these facilities. The assignments of these military personnel are rotated frequently, and they typically do not reside on the island for longer than a year or two.
KeywordsAmyotrophic Lateral Sclerosis Amyotrophic Lateral Sclerosis Patient Motor Neuron Disease Lower Motor Neuron Parkinsonism Dementia
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