title: A cluster of multiple sclerosis cases in Lysvik in the Swedish county of Värmland.
abstract: OBJECTIVE
  When surveying the county of Värmland in Sweden in order to determine the prevalence of multiple sclerosis (MS), we observed an aggregation of MS cases originating from the parish of Lysvik in the local region called Fryksdalen. Our intention was to analyse this cluster thoroughly, confirming the MS diagnosis and seeing if a hereditary or environmental background was plausible.
  
  
  METHODS
  The medical files were studied and the cases were classified by a neurologist according to Poser's criteria. Hereditary factors were analysed.
  
  
  RESULTS
  Sixteen living cases of MS were found, either living in the parish (n = 6) or born or raised there and had later moved to another place (n = 10). All patients had clinically definite MS. Eleven patients had relatives with MS, all of these being descendants of the Suhoinen family. Another two cases were Suhoinen descendants who did not have relatives with MS. Other common ancestors were also identified. Two cases were adopted. Eleven deceased MS patients from Lysvik were found, 10 of them had Suhoinen ancestry.
  
  
  CONCLUSIONS
  We report a cluster of MS cases with a common ancestry indicating heredity for MS in 85% of the cases. Lysvik is a parish where Finnish immigration was pronounced in the 17th century and there has been inbreeding to a certain extent through marriage between cousins. Thus, we interpret this aggregation as possibly being genetically based, and neurogenetic studies are now being performed. However, as two of the cases were adopted environmental factors must also be considered.
authors.affiliation: Department of Neuroscience and Locomotion, Division of Neurology, Faculty of Health Sciences, University of Linköping, Linköping, Sweden. margarita.callander@lio.se
authors.forename: M
authors.initials: M
authors.lastname: Callander
authors.forename: A-M
authors.initials: AM
authors.lastname: Landtblom
mesh_terms: D016000:Cluster Analysis; D003241:Consanguinity; D004641:Emigration and Immigration; D005260:Female; D005387:Finland / Q000208:ethnology; D030342:Genetic Diseases, Inborn / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006801:Humans; D008297:Male; D009026:Mortality; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics; D010375:Pedigree; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology