During a ten-year period, four cases of amyotrophic lateral sclerosis have been found in a sparsely populated county (population 4,000) in westcentral South Dakota. The patients were unrelated male farmer-ranchers between 57 and 66 years of age, living within a 15-km radius of each other. The cases occurred in a region where naturally occurring selenium toxication is endemic in farm animals.
(JAMA 237:2843-2844, 1977)
Kilness AW, Hochberg FH. Amyotrophic Lateral Sclerosis in a High Selenium Environment. JAMA. 1977;237(26):2843–2844. doi:10.1001/jama.1977.03270530051023
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