Neurolathyrism

1
Neurolathyrism

• Haileyesus Getahun
• South Gonder Health Department, Ethiopia

2
Neurolathyrism

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

3
The Toxin

• The pulse contains the neurotoxin called
  ?-N-oxalyl-?,?-diaminopropionic acid
  (?-ODAP).Synonym ?-oxalylaminoalanine(BOAA)

4
Grass pea

• Resist water shortage and water logging.
• Improves soil fertility.
• Needs no fertilizer.
• Gives high yield.

5
History of Neurolathyrism

• Ancient disease.
• Often occurs in epidemics.
• Several epidemics occurred in most parts of the
  world.

6
Prevalence

• Varies from country to country.
• Often occur in inaccessible areas.
• Not many epidemiological studies.

7
Mean Prevalence

• Ethiopia 6 per 1000
• India 5.3 per 1000
• Bangladesh 1.4 per 1000.

8
Recent epidemics

• 1973 China
• 1976 Bangladesh
• 1976 Ethiopia
• 1998 Nepal (non published)
• 1998 Afghanistan (non published)
• 1997-99 Ethiopia

9
Onset of the disease

• Mostly 3-6 months.
• Acute or chronic.
• Dose dependent.
• Critical level 400gm/day.

10
Risk factors

• Heavy physical activity
• Male gender
• Young age (15-25 years)
• Micro nutrient deficiency (Zn,Cu, Vit C, Vit A)

11
Clinical features

• Upper motor neuron disorder with symmetrical
  spastic paralysis.
• Sensation and sphincters are spared.

12
Stages of the disease

• Stage I (No stick stage)
• Stage II (One stick stage)
• Stage III (Two sticks stage)
• Stage IV (Crawler stage)

13
Treatment

• No definitive treatment.
• The neuronal damages are permanent.
• Symptomatic treatment with muscle relaxants help.

14
Prevention

• Home based detoxifying methods.
• New seed lines.
• Cultivation of alternate crops.

15
Prevention

• Although cultivation of the grass pea is
  legally banned
• in India and Nepal,
• Neurolathyrism continued to manifest
  itself.