The clinical syndrome of FOSMN was first described in 2006, several years after our patient’s death.2 Further histologic analysis was prompted by reports of TDP43 inclusions in postmortem tissue of patients with FOSMN.8 At the time of our patient's illness, mutations in C9ORF72, FUS, and TARDBP had not yet been discovered to cause ALS. The gene discussed is C9orf72; the disease is amyotrophic lateral sclerosis.