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September 2000

Defining the Neurological Basis of the Gulf War Syndrome

Arch Neurol. 2000;57(9):1263. doi:10.1001/archneur.57.9.1263

HALEY AND colleagues,13 and the Iowa Persian Gulf Study Group,4 in a series of articles in JAMA in 1997, presented evidence of a Persian Gulf War (PGW) syndrome made up of 6 subtypes: (1) impaired cognition; (2) confusion-ataxia; (3) arthromyoneuropathy; (4) phobia apraxia; (5) fever adenopathy; and (6) weakness and incontinence. Comprehensive neuropsychological testing, brainstem auditory evoked potentials, somatosensory evoked potentials, and other detailed neurophysiological test results were abnormal in Gulf War veterans compared with control subjects. Exposure of military personnel with a genetically based susceptibility to chemicals such as pyridostigmine bromide, organophosphates, other cholinesterase-inhibiting chemicals, pesticides, and insect repellents is thought to cause the syndrome. Military personnel who participated in the PGW had a higher self-reported prevalence of medical and psychiatric conditions than other veterans who did not serve in the PGW.14 The issue for the past several years has been to establish a convincing neuroscientific basis for the PGW syndrome by documenting neurochemical or molecular data strongly supportive of the syndrome's causation.

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