Long-term follow-up of konzo patients.
Nine patients with konzo, a symmetric spastic paraparesis of acute onset that occurs during agricultural crises in cassava-growing areas, were re-examined after 14 years. Konzo outbreaks are associated with eating insufficiently processed bitter cassava and a low intake of essential amino acids. Bitter cassava contains cyanogenic glycosides; processing breaks them down to acetone cyanohydrin and hydrogen cyanide. This long-term follow-up showed that the neurological signs in konzo patients remained constant. Four severely affected patients, however, showed functional improvement. This non-progression clearly distinguishes konzo from myelopathy associated with human T lymphotropic virus type I infection. One child, originally classified as a konzo case, showed signs of cretinism at follow-up.
Cliff
J
J
Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique. jcliff@med1.uem.mz
Nicala
D
D
D000328:Adult; D000601:Amino Acids, Essential / Q000172:deficiency*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D005511:Food Handling; D006801:Humans; D008297:Male; D002365:Manihot / Q000009:adverse effects*; D010291:Paresis / Q000209:etiology* / Q000503:physiopathology
D000601:Amino Acids, Essential