The introduction of palliative therapies in amyotrophic lateral sclero
sis (ALS) will alter the epidemiology of ALS as it is known now. Altho
ugh incidence rates will remain unchanged in the near future, prevalen
ce rates will likely increase dramatically. Better understanding of th
e age-specific presentation of motor neuron diseases worldwide will sh
ed light on the vexing questions concerning the variable incidence rat
es in some countries and apparent incidence gradients in North America
and Europe.