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The suggestion that amyotrophic lateral sclerosis (ALS) was triggered by Gulf War service was first proposed when cases began to occur in young servicemen at an age when ALS is uncommon.1 This proposal gained widespread publicity following the formal recognition of ALS as a Gulf War–related illness by the Veterans Administration of the United States.2 This decision was made on humane and political grounds but has been taken as quasi-scientific validation for the claims. Two articles in this issue of Neurology, one by Haley and the other by Horner et al., allow readers to judge for themselves the scientific basis of claims of an excess risk of developing ALS in Gulf War veterans.3,4⇓ These studies used both passive and active ascertainment of ALS cases using recruitment via military and health records and publicity campaigns among military personnel and their caregivers. Cases were then confirmed by case record review supplemented mostly by telephone and personal inquiries. Both studies almost …
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