Neurolathyrism
Neurolathyrism, is a neurological disease of humans, caused by eating certain legumes of the genus Lathyrus. This disease is mainly associated with the consumption of Lathyrus sativus (also known as grass pea, chickling pea, kesari dal, or almorta) and to a lesser degree with Lathyrus cicera, Lathyrus ochrus and Lathyrus clymenum containing the toxin ODAP. This is not to be confused with osteolathyrism, a different type of lathyrism that affects the connective tissues. Osteolathyrism results from the ingestion of Lathyrus odoratus seeds (sweet peas) and is often referred to as odoratism. It is caused by a different toxin (beta-aminopropionitrile) which affects the linking of collagen, a protein of connective tissues. Another type of lathyrism is angiolathyrism which is similar to osteolathyrism in its effects on connective tissue. However, the blood vessels are affected as opposed to bone. Signs and symptoms The consumption of large quantities of Lathyrus seeds containing high concentrations of the neurotoxic glutamate analogue β-oxalyl-L-α,β-diaminopropionic acid (ODAP, also known as β-N-oxalyl-amino-L-alanine, or BOAA) causes paralysis, characterized by lack of strength in or inability to move the lower limbs, and may involve pyramidal tracts, producing signs of upper motor neuron damage. The toxin may also cause aortic aneurysm. A unique symptom of lathyrism is the atrophy of gluteal (buttocks) muscles. ODAP is a poison of the mitochondria, leading to excess cell death, especially in motor neurons. Children can additionally develop bone deformity and reduced brain development. Related conditions A related disease has been identified and named osteolathyrism, because it affects the bones and connecting tissues, instead of the nervous system. It is a skeletal disorder, caused by the toxin beta-aminopropionitrile (BAPN), and characterized by hernias, aortic dissection, exostoses, and kyphoscoliosis and other skeletal deformities, apparently as the result of defective aging of collagen tissue. The cause of this disease is attributed to beta-aminopropionitrile, which inhibits the copper-containing enzyme lysyl oxidase, responsible for cross-linking procollagen and proelastin. BAPN is also a metabolic product of a compound present in sprouts of grasspea, pea and lentils. Disorders that are clinically similar are konzo and lytico-bodig disease. Causes The toxicological cause of the disease has been attributed to the neurotoxin ODAP which acts as a structural analogue of the neurotransmitter glutamate. Lathyrism can also be caused by deliberate food adulteration. Association with famine Ingestion of legumes containing the toxin occurs despite an awareness of the means to detoxify Lathyrus. Drought conditions can lead to shortages of both fuel and water, preventing the necessary detoxification steps from being taken, particularly in impoverished countries. Lathyrism usually occurs where the combination of poverty and food insecurity leaves few other food options. Diagnosis There are no diagnostic criteria for neurolathyrism. Diagnosis is based on clinical features and exclusion of other diagnoses. Prevention Eating the chickling pea with legumes having high concentrations of sulphur-based amino acids reduces the risk of lathyrism if such grain is available. Food preparation is also an important factor. Toxic amino acids are readily soluble in water and can be leached. Bacterial (lactic acid)