Lathyrism, considered to be a rare occurrence in clinical practice today, is a disease arising due to prolonged and excessive consumption of Lathyrus sativus legume, more commonly known as grass pea or chickling pea [1] [2] [3]. In limited concentrations, L. sativus is a part of the normal diet in many countries and lathyrism usually appears in times of profound famine from severe droughts or floods, as the legume can survive extremely dry conditions and tolerates floods as well [2] [3] [4]. Although previously documented throughout the world, three countries have reported the vast majority of cases in the previous decades - Ethiopia, Bangladesh, and India [1] [2] [4] [5] [6]. Lathyrism stems from ingestion of a neurotoxic excitatory beta-N-oxalylamino-L-alanine amino acid (BOAA) during droughts in very high amounts for at least a few months, and the term "staple diet" is often used to describe the excessive dietary intake of a certain food [5] [7]. BOAA seems to directly promote symmetric degeneration of anterior horn cells and upper motor neurons in the spinal cord, as well as pyramidal cells responsible for leg movement located in the primary motor cortex [3] [5] [7], with inhibition of mitochondrial activity being the presumable mechanism of disease [6]. Consequently, the principal clinical manifestation of lathyrism is non-progressive spastic paraparesis of the lower limbs [1] [2] [5]. In addition to neurotoxic effects, some studies have identified bone pain as a symptom of lathyrism and marked skeletal changes on radiographic studies [8].

• Hunting

  […] problems if doses do not exceed 50 percent of the ration.Ronald Hamilton suggested in his paper The Silent Fire: ODAP and the death of Christopher McCandless that itinerant traveler Christopher McCandless may have died from starvation after being unable to hunt [en.wikipedia.org]

• Difficulty Walking

  Central motor conduction times corresponding to lower limbs were clearly more prolonged in those severely affected patients with marked difficulty walking (Stages 4 and 3). [ncbi.nlm.nih.gov]

• Prisoner of War

  In 1947, Kessler published a vivid account of the toxicity of L sativus among the Romanian prisoners of war during the Second World War ( Kessler 1947 ). [medlink.com]

• Scissoring Gait

  Pyramidal tract involvement causes: Motor weakness Increased tone A lurching scissoring gait caused by involvement of the thigh extensors and adductors and gastrocnemius Extensor plantar responses Very brisk knee and ankle tendon reflexes, often clonic [patient.info]

• Joint Dislocation

  Discussion: - lathyritic animals are known to have soft, deformed bones, many joint dislocations, and aortic aneurysms; - if the extracellular processes of cross-link formation are inhibited, collagen will remain soluble, which is the case in a disease [wheelessonline.com]

• Spastic Paralysis

  […] lath·y·rism \ ˈla-thə-ˌri-zəm \ : a neurotoxic disorder chiefly affecting people and domestic animals (such as cows and horses) that is characterized especially by irreversible spastic paralysis of the hind or lower limbs and that results from poisoning [merriam-webster.com]

  Retrieved May 29th, 2019, from lathyrism noun A disease of humans and animals caused by eating legumes of the genus Lathyrus and characterized by spastic paralysis, hyperesthesia, and paresthesia. [yourdictionary.com]

  Neurolathyrism is a crippling disease characterized by gradually developing spastic paralysis of lower limbs, occurring mostly in adults consuming pulse, Lathyrus sativus in large quantities over a period of time for 2 months or more. c. [gradestack.com]

• Hyperesthesia

  Definitions lath·y·rism a painful, poisoned condition caused by the ingestion of certain peas (esp. genus Lathyrus ) and characterized by paralysis of the legs, hyperesthesia, etc. [yourdictionary.com]

  Copyright HarperCollins Publishers lathyrism in American ( ˈlæθəˌrɪzəm ; la t h ˈərizˌəm ) noun a painful, poisoned condition caused by the ingestion of certain peas (esp. genus Lathyrus ) and characterized by paralysis of the legs, hyperesthesia, etc [collinsdictionary.com]

  Hyperesthesia.. Paresthesia.. Angiolathyrism - causes sudden death.. Aneurisms.. Osteolathyrism - affects skeletal development, cartilages and bones grow abnormally - deformity of the body.. Development of brain stops. [specialityclinic.com]

  (genus ... (23 of 66 words, pronunciations) www.merriam-webster.com/dictionary/lathyrism American Heritage Dictionary: lathyrism A disease of humans and animals caused by eating legumes of the genus "Lathyrus" and characterized by spastic paralysis, hyperesthesia [memidex.com]

• Myelopathy

  McCandless’s body was autopsied or whether spinal cord sections were included that might corroborate the presence of a toxic myelopathy. But with all of those caveats, the linked articles are some very interesting reads! About Justin A. [ghostofcharcot.net]

  Ingestion of large amounts of poorly processed cassava roots is associated with the occurrence of an epidemic form of a noncompressive myelopathy (konzo) in African countries. [medlink.com]

  […] two-stick and the crawler stages (Park, 2009) when the unsteadiness of gait progresses to muscular spasticity and paraplegia of lower extremities (Karmakar, 2007) accompanied by muscular atrophy (Park, 2009), making it one of the most dreadful toxic spastic myelopathies [isebindia.com]

• Spastic Paraplegia

  Clinical manifestations are marked by spastic paraplegia, and degenerative pathological changes are noted in the spinal cord to account for this effect. [doi.org]

  Progressive spastic paraplegia.. Pain.. Hyperesthesia.. Paresthesia.. Angiolathyrism - causes sudden death.. Aneurisms.. Osteolathyrism - affects skeletal development, cartilages and bones grow abnormally - deformity of the body.. [specialityclinic.com]

  Main involvement is spastic paraplegia with exaggerated tendon jerks and extensor response plantar. Predominantly there is involvement of the cord between T12 and Li segments. The upper limbs usually escape and there is no wasting of muscles. [healthdrip.com]

• Paresthesia

  Retrieved May 29th, 2019, from lathyrism noun A disease of humans and animals caused by eating legumes of the genus Lathyrus and characterized by spastic paralysis, hyperesthesia, and paresthesia. [yourdictionary.com]

  Paresthesia.. Angiolathyrism - causes sudden death.. Aneurisms.. Osteolathyrism - affects skeletal development, cartilages and bones grow abnormally - deformity of the body.. Development of brain stops. Dietary management for Lathyrism. [specialityclinic.com]

The diagnosis of lathyrism might be difficult to make without a properly obtained patient history and a complete neurological examination. A thorough nutritional assessment, during which ingestion of grass pea or chickling pea should be investigated, might be of critical importance, and some studies have confirmed that consumption of boiled or raw unripe grass pea significantly increases the risk of neurological symptoms [2]. Because famine and droughts are regarded as necessary events for lathyrism to appear [2] [3], epidemiological data are equally useful in order to make a provisional diagnosis. For the still unknown reason, males more commonly suffer from lathyrism compared to females [3]. The neurological assessment must include reflex testing and evaluation of movement, particularly of the lower extremities, and in the case of spastic paraparesis or even paralysis, clinical suspicion can be raised toward lathyrism. When bone pain is reported, plain radiography might be suggested, as skeletal deformities have been documented [8]. As no specific tests exist, the diagnosis of lathyrism depends on the ability of the physician to recognize main signs of the disease and support those findings with information from the patient interview.

1. Spencer PS, Schaumburg HH. Lathyrism: a neurotoxic disease. Neurobehav Toxicol Teratol. 1983;5(6):625-629.
2. Getahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Food-aid cereals to reduce neurolathyrism related to grass-pea preparations during famine. Lancet. 2003;362:1808–1810.
3. Getahun H, Lambein F, Vanhoorne M, Van der Stuyft P. Neurolathyrism risk depends on type of grass pea preparation and on mixing with cereals and antioxidants. Trop Med Int Health. 2005;10(2):169-178.
4. Singh SS, Rao SLN. Lessons from neurolathyrism: A disease of the past & the future of Lathyrus sativus (Khesari dal). Indian J Med Res. 2013;138(1):32-37.
5. Haimanot RT, Kidane Y, Wuhib E, et al. The epidemiology of lathyrism in north and central Ethiopia. Ethiop Med J. 1993;31(1):15-24.
6. Haimanot RT, Kidane Y, Wuhib E, et al. Lathyrism in rural northwestern Ethiopia: a highly prevalent neurotoxic disorder. Int J Epidemiol. 1990;19(3):664-672.
7. Ravindranath V. Neurolathyrism: mitochondrial dysfunction in excitotoxicity mediated by L-beta-oxalyl aminoalanine. Neurochem Int. 2002;40(6):505-509.
8. Haque A, Hossain M, Lambein F, Bell EA. Evidence of osteolathyrism among patients suffering from neurolathyrism in Bangladesh. Nat Toxins. 1997;5(1):43-46.