We determined whole blood lead and cadmium levels, and serum selenium levels in patients with sporadic amyotrophic lateral sclerosis and age- and sex-matched controls. Disability due to the disease directly correlated with lead levels, and there was a strong inverse correlation with selenium concentrations. Lead and selenium concentrations tended to be similar in the cases and controls, both in the study population as a whole and after the removal from the analysis of the patients with the highest degree of disability. In the patients with limited disability, cadmium concentrations were higher than in the controls. Our findings lend limited support to a possible involvement of cadmium, but not lead, in the etiology of sporadic amyotrophic lateral sclerosis, and strongly suggest that short-term indicators of exposure are inadequate to investigate the relationship between selenium and the disease.

We carried out a retrospective incidence, prevalence and mortality survey of amyotrophic lateral sclerosis (ALS) in the province of Reggio Emilia, northern Italy. Based on 79 patients, the mean incidence per year for the period 1980 through 1992 was 1.5 cases per 100,000. On December 31st, 1992, the prevalence rate was 5.4 per 100,000. In the 10-year period of 1983–1992 the average mortality rate was 1.3 per 100,000 per year. The average age at onset was 61.3 ± 10.2, the average survival period thereafter was 26.3 months ± 17.7; 27.3 ± 17.6 for classic ALS, 19.5 ±8.4 for progressive bulbar palsy and 36.3 ±41.4 for pseudopolyneuritic ALS. The incidence rate, recorded in public health district No. 12, an area with documented lead pollution since the 1970s, was standardized to the sex and age of the population of the province. Its incidence and prevalence rate were comparable to the rates found in the remaining area of the province.

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We present the results of an epidemiological survey on MS conducted in the provinces of Reggio Emilia and Modena (4,980 km²) from 1970 to 1990. The population increased from 943,182 residents in 1970 to 1,024,223 in 1990, with an average population during the period of the survey of 993,056. The mean annual incidence was 1.59 cases/100,000 inhabitants (c.i. 95% 1.42–1.78). The prevalence as of December 31, 1990, was 39.44/100,000 inhabitants. Our study is a further demonstration that Italy is a high-risk zone for this disease, and also demonstrates the possibility of carrying out reliable epidemiological surveys even over extensive territories.

✓ A case of cerebral oligodendroglioma with a large metastasis in the spinal cord is reported. The patient had undergone two intracranial operations (1959 and 1961) before the successful removal (1966) of the spinal metastasis, and is still alive.