|
Lathyrism: The Ultimate Crippling Disease
By: Avik Basu1 and Saikat Kumar Basu2
In a big country like
India, housing people of diverse castes, customs and habits, the
staple food items of daily diet vary a great deal. From boiled rice
to biryanis and from idli to tandooris almost every single edible
goody has found its place in the ever-extending list of daily Indian
cuisine according to the choice of people and the conditions
favoring the growth of the principal food grains in the particular
areas of the country. But this daily consumption of some specific
food-crops in some specific districts of India has given rise to
development of some complicating diseases that may lead to
disabilities and deformities in the human body and also, fatality of
which Lathyrism stands out as a prominent member. Lathyrism is a
crippling disease that may occur in human beings as well as in other
animals, the former being known as neurolathyrism and the latter
osteolathyrism according to the part of the body involved (Park,
2009). The main causative agent behind this disease is ‘Khesari dal’
(Lathyrus sativus L.) containing a potentially lethal
neurotoxin BOAA (Karmakar, 2007). This food grain is consumed mainly
by the field workers of Madhya Pradesh, Uttar Pradesh, Bihar and
Orissa due to their cheap prices (Park, 2009). Consumption of
‘Khesari dal’ for a continuous period of 2-6 months, with this food
grain accounting for about 30% of daily diet will lead to Lathyrism
(Park, 2009). Cases of Lathyrism outside India have been reported
from Spain and Algeria (Park, 2009).
The disease mainly
manifests in the age group of 15-45 years in four successive stages
in untreated cases (Park, 2009). In the initial or latent stage, the
individual displays only unsteadiness of gait and is otherwise
normal (Park, 2009). Then comes the no-stick stage when the person
walks, without the help of a stick, with short jerky paces (Park,
2009). This is followed by one-stick, 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 (Hauser and Ropper,
2008).
No specific treatment
regimen has yet been formulated. Prevention is thus the only
management procedure. This includes removal of the toxin by
parboiling of rice (Park, 2009), restricting consumption of the food
grain to less than 25% of daily diet (Karmakar, 2007) and also
Vitamin C prophylaxis (Park, 2009).
1Medical College
Kolkata, WB India; 2University of Lethbridge, AB Canada
E-mail: [email protected] |
