Neurolathyrism
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Neurolathyrism. Haileyesus Getahun South Gonder Health Department, Ethiopia. Neurolathyrism. Synonym lathyrism Neurolathyrism (NL) is a neurodegenerative disease that is caused by heavy consumption of grass pea, Lathyrus sativus. The Toxin.

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Neurolathyrism

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Neurolathyrism

Neurolathyrism

Haileyesus Getahun

South Gonder Health Department, Ethiopia


Neurolathyrism1

Neurolathyrism

  • Synonym lathyrism

  • Neurolathyrism (NL) is a neurodegenerative disease that is caused by heavy consumption of grass pea, Lathyrus sativus.


The toxin

The Toxin

The pulse contains the neurotoxin called -N-oxalyl-,-diaminopropionic acid (-ODAP).[Synonym -oxalylaminoalanine(BOAA)]


Grass pea

Grasspea

  • Resist water shortage and water logging.

  • Improves soil fertility.

  • Needs no fertilizer.

  • Gives high yield.


History of neurolathyrism

History of Neurolathyrism

  • Ancient disease.

  • Often occurs in epidemics.

  • Several epidemics occurred in most parts of the world.


Prevalence

Prevalence

  • Varies from country to country.

  • Often occur in inaccessible areas.

  • Not many epidemiological studies.


Mean prevalence

Mean Prevalence

  • Ethiopia 6 per 1000

  • India 5.3 per 1000

  • Bangladesh 1.4 per 1000.


Recent epidemics

Recent epidemics

  • 1973 : China

  • 1976: Bangladesh

  • 1976: Ethiopia

  • 1998: Nepal (non published)

  • 1998: Afghanistan (non published)

  • 1997-99: Ethiopia


Onset of the disease

Onset of the disease

  • Mostly 3-6 months.

  • Acute or chronic.

  • Dose dependent.

  • Critical level = 400gm/day.


Risk factors

Risk factors

  • Heavy physical activity

  • Male gender

  • Young age (15-25 years)

  • Micro nutrient deficiency (Zn,Cu, Vit C, Vit A)


Clinical features

Clinical features

  • Upper motor neuron disorder with symmetrical spastic paralysis.

  • Sensation and sphincters are spared.


Stages of the disease

Stages of the disease

  • Stage I (No stick stage)

  • Stage II (One stick stage)

  • Stage III (Two sticks stage)

  • Stage IV (Crawler stage)


Treatment

Treatment

  • No definitive treatment.

  • The neuronal damages are permanent.

  • Symptomatic treatment with muscle relaxants help.


Prevention

Prevention

  • Home based detoxifying methods.

  • New seed lines.

  • Cultivation of alternate crops.


Prevention1

Prevention

Although cultivation of the grass pea is legally banned

in India and Nepal,

Neurolathyrism continued to manifest itself.


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