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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
The pulse contains the
 neurotoxin called -N-
 oxalyl-,-diaminopropionic
 acid (-ODAP).[Synonym -
 oxalylaminoalanine(BOAA)]
        Grass pea
• Resist water shortage and
  water logging.
• Improves soil fertility.
• Needs no fertilizer.
• Gives high yield.
       History of
     Neurolathyrism
• Ancient disease.
• Often occurs in epidemics.
• Several epidemics occurred
  in most parts of the world.
        Prevalence
• Varies from country to
  country.
• Often occur in inaccessible
  areas.
• Not many epidemiological
  studies.
   Mean Prevalence

• Ethiopia 6 per 1000
• India 5.3 per 1000
• Bangladesh 1.4 per 1000.
      Recent epidemics
• 1973 : China
• 1976: Bangladesh
• 1976: Ethiopia
• 1998: Nepal (non published)
• 1998: Afghanistan (non published)
• 1997-99: Ethiopia
  Onset of the disease
• Mostly 3-6 months.
• Acute or chronic.
• Dose dependent.
• Critical level = 400gm/day.
       Risk factors
• Heavy physical activity
• Male gender
• Young age (15-25 years)
• Micro nutrient deficiency
  (Zn,Cu, Vit C, Vit A)
    Clinical features
• Upper motor neuron disorder
  with symmetrical spastic
  paralysis.
• Sensation and sphincters are
  spared.
  Stages of the disease
• Stage I (No stick stage)
• Stage II (One stick stage)
• Stage III (Two sticks stage)
• Stage IV (Crawler stage)
       Treatment
• No definitive treatment.
• The neuronal damages are
  permanent.
• Symptomatic treatment with
  muscle relaxants help.
        Prevention
• Home based detoxifying
  methods.
• New seed lines.
• Cultivation of alternate
  crops.
       Prevention
Although cultivation of the
grass pea is legally banned
   in India and Nepal,
    Neurolathyrism
continued to manifest itself.

				
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posted:4/11/2008
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