Lathyrism
| Lathyrism | |
|---|---|
| Synonyms | Neurolathyrism, Osteolathyrism |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Spasticity, paralysis of the lower limbs |
| Complications | Permanent disability |
| Onset | Gradual, after prolonged consumption of certain Lathyrus species |
| Duration | Chronic |
| Types | N/A |
| Causes | Consumption of Lathyrus sativus (grass pea) containing ODAP |
| Risks | Malnutrition, drought, famine |
| Diagnosis | Clinical evaluation, dietary history |
| Differential diagnosis | Multiple sclerosis, tropical spastic paraparesis |
| Prevention | Avoidance of Lathyrus sativus in diet |
| Treatment | Physical therapy, supportive care |
| Medication | N/A |
| Prognosis | Variable, often leads to permanent disability |
| Frequency | Rare, endemic in certain regions of Africa and Asia |
| Deaths | N/A |
Lathyrism is a neurological disease caused by the consumption of certain legumes from the genus Lathyrus, particularly the species Lathyrus sativus (also known as grass pea, chickling vetch, or Indian pea). The disease is characterized by progressive spastic paraplegia, which results in a stiff and awkward gait.
Etiology
Lathyrism is caused by the ingestion of the neurotoxin β-N-oxalyl-L-α,β-diaminopropionic acid (ODAP), also known as β-L-oxalylamino-L-alanine (BOAA). This compound is found in high concentrations in the seeds of Lathyrus sativus and other Lathyrus species. The toxin is resistant to cooking and other forms of food processing.
Epidemiology
Lathyrism is most commonly found in regions where Lathyrus sativus is a staple food, particularly during times of famine. This includes parts of South Asia, East Africa, and the Mediterranean region. The disease is more prevalent in males, possibly due to their higher consumption of Lathyrus seeds.
Clinical Presentation
The symptoms of lathyrism typically begin with weakness and stiffness in the legs. This progresses to spastic paraplegia, a condition characterized by increased muscle tone and spasms in the lower limbs. Other symptoms may include numbness, tingling, and pain in the affected limbs. In severe cases, the disease can lead to complete paralysis.
Diagnosis
Diagnosis of lathyrism is primarily based on the patient's dietary history and clinical symptoms. Laboratory tests may be used to detect the presence of ODAP in the patient's blood or urine.
Treatment and Prevention
There is currently no cure for lathyrism. Treatment is focused on managing symptoms and preventing further consumption of Lathyrus seeds. Physical therapy may be beneficial for improving mobility and reducing muscle stiffness. Prevention strategies include education about the risks of consuming Lathyrus seeds and promoting alternative food sources.
See Also
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Contributors: Prab R. Tumpati, MD