Opinion: Conjugal amyotrophic lateral sclerosis

en-titled “Conjugal Amyotrophic Lateral Sclerosis”. There are several reports, as mentioned by the au-thors, in the literature, describing the almost simultane-ously appearance of sporadic amyotrophy lateral sclero-sis (SALS) in a couple, no genetically related, living to -gether for a long time.Of course, this circumstance strongly suggests the ex-istence of an environmental factor triggering the disease in people, perhaps, genetically susceptible. The search for such factors has been, and it is, one of the main topics of research in SALS.However, the particular description of Godeiro et al., as far as I can understand, does not follow the rigid clini-cal diagnostic concept of SALS, which requires the pres-requires the pres-ence of lower and upper motor neurons clinical involve-ment. This happens neither with the husband of couple I, nor with the husband of family II. Both men seem to be affected by a dennervatory condition involving, apparent-ly, just the lower motor neuron.According to “El Escorial” criteria (1991) the isolat-ed compromise of the spinal motor neuron reaches the 4