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2% of our cohort. mutation involved all types of pedigrees. No nor mutation was present in monogenerational pedigrees. mutation predominated in bigenerational pedigrees with at least three cases and mutation in multigenerational pedigrees with more than seven cases, on average, and with an age of onset younger than 45 years. Our results suggest that familial clustering, phenotypes and genotypes are interconnected in FALS, and thus it might be possible to target the genetic screening from the familial architecture and the phenotype of AL