Journal of the Neurological Sciences
Volume 296, Issue 1 , Pages 30-33 , 15 September 2010

Etiology of Konzo, epidemic spastic paraparesis associated with cyanogenic glycosides in cassava: Role of thiamine deficiency?

Received 30 March 2010 ,Revised 25 May 2010 ,Accepted 16 June 2010.

References 

  1. Tylleskar T, Howlett WP, Rwiza HT, Aquilonius S-M, et al. Konzo: a distinct disease entity with a selective upper motor neuron damage. J Neurol Neurosurg Psychiatry. 1993;56:638–643
  2. Howlett WP, Brubaker GR, Mlingi N, Rosling H. Konzo, an epidemic upper motor neuron disease studied in Tanzania. Brain. 1990;113(1):223–235
  3. Tylleskar T, Legue FD, Peterson S, Kpizingui E, Stecker P. Konzo in the Central African Republic. Neurology. 1994;44:959
  4. Cliff J, Nicala D, Saute F, Givragy R, Azambuja G, Taela A, et al. Konzo associated with war in Mozambique. Trop Med Int Health. 1997;2:1068–1074
  5. Muquingue H, Nhassico D, Cliff J, Sitoe L, Tonela A, Bradbury JH. In: Field trial in Mozambique of a new method for detoxifying cyanide in cassava products. CCDN News. 6:2005;p. 3–4
  6. Ministry of Health, Mozambique . Mantakassa: an epidemic of spastic paraparesis associated with chronic cyanide intoxication in a cassava staple area of Mozambique. 1. Epidemiology and clinical laboratory findings in patients. Bull World Health Organ. 1984;62(3):477–484
  7. Tylleskar T, Banea M, Bikangi N, Fresco L, Persson LA, Rosling H. Epidemiological evidence from Zaire for a dietary etiology of Konzo, an upper motor neurone disease. Bull World Health Organ. 1991;69(5):581–589
  8. Tylleskar T. The association between cassava and the paralytic disease Konzo. Acta Hortic. 1994;375:331–339
  9. Cliff J, Muquinque H, Nhassico D, Nzwalo H, Bradbury JH. In: Konzo and continuing cyanide intoxication from cassava in Mozambique. CCDN News. 14:2009;p. 4–5
  10. Mlingi NLV, Nkya S, Tatala SR, Ngude H, Bradbury JH. In: Reoccurrence of Konzo in cassava-consuming districts in southern Tanzania. CCDN News. 14:2009;p. 5
  11. Earnesto M, Cardoso AP, Nicala D, Mirione E, Massaza F, Cliff J, et al. Persistent Konzo and cyanide toxicity from cassava in northern Mozambique. Acta Trop. 2002;82:357–362
  12. Ministry of Health, Mozambique . Mantakassa: an epidemic of spastic paraparesis associated with chronic cyanide intoxication in a cassava staple area of Mozambique. 2. Nutritional factors and hydrocyanic acid content of cassava products. Bull World Health Organ. 1984;62(3):485–492
  13. Cliff J, Lundquist P, Martenson J, Rosling H, Sorbo B. Association of high cyanide and low sulfur intake in cassava-induced spastic paraparesis. Lancet. 1985;1211–1213
  14. Lundquist P, Backman-Gullers B, Kagedal B. Fluorometric determination of cyanate in plasma by conversion to 2, 4 (1H, 3H)-quinazolinedione and separation by high performance liquid chromatography. Anal Biochem. 1993;211:23–27
  15. Tor-Agbidye J, Palmer VS, Lasarev MR, Craig MA, Blythe LL, Sabri MI, et al. Bioactivation of cyanide to cyanate in sulfur amino acid deficiency: relevance to neurologic disease in humans subsisting on cassava. Toxicol Sci. 1999;50:228–235
  16. Tellez I, Johnson D, Nagel RL, Cerami A. Neurotoxicology of sodium cyanate: new pathological and ultrastructural observations in Macaca nemestrina. Acta Neuropathol. 1979;47(1):75–79
  17. Tellez-Nagel I, Korthals JK, Vlassara HV, Cerami A. An ultrastructural study of chronic sodium cyanate-induced neuropthy. J Neuropathol Exp Neurol. 1977;36:351–363
  18. Carton H, Kayembe K, Kabeya , Odio , et al. Epidemic spastic paraparesis in Bandundu (Zaire). J Neurol Neurosurg Psychiatry. 1986;49:620–627
  19. Jeannel D, Garin B, Kazadi K, Singa L, de The G. The risk of tropical spastic paraparesis differs according to ethnic group among HTLV-1 carriers in Inongo, Zaire. J Acquir Immune Defic Synd. 1993;6:840–844
  20. Tylleskar T, Banea M, Bottiger B, Thorstensson R, Biberfeld G, Rosling H. Konzo, an epidemic spastic paraparesis in Africa, is not associated with antibodies to HTLV-1, HIV or HIV gag-encoded proteins. J Acquir Immune Defic Synd. 1996;12(3):317–318
  21. Nhassico D, Muquingue H, Cliff J, Cumbana A, Bradbury JH. Rising African cassava production, diseases due to cyanide intake and control measures. J Sci Food Agric. 2008;88:2043–2049
  22. Tylleskar T, Banea M, Bikangi N, Cooke RD, Poulter NH, Rosling H. Cassava cyanogens and Konzo, an upper motor neurone disease found in Africa. Lancet. 1992;339(8787):208–211
  23. Banea-Mayambu JP, Tylleskar T, Gitebo N, Matadi N, Gebre-Medhin M, Rosling H. Geographic and seasonal association between linamarin and cyanide exposure from cassava and the upper motor neurone disease Konzo in former Zaire. Trop Med Int Health. 1997;12:1143–1151
  24. Akintonwa A, Tunwashe OL. Fatal cyanide poisoning from cassava-based meal. Hum Exp Toxicol. 1992;11(1):47–49
  25. Carella F, Grassi M, Savoiardo M, et al. Dystonic-parkinsonian syndrome after cyanide poisoning: clinical and MRI findings. J Neurol Neurosurg Psychiatry. 1988;51:1345–1348
  26. Soler-Martin C, Riera J, Seoane A, Cutillas B, Ambrosio S, Boadas-Vaello P, et al. The targets of acetone cyanohydrin neurotoxicity in the rat are not the ones expected in an animal model of Konzo. Neurotoxicol Teratol. 2010;32(2):289–294
  27. Sreeja VG, Nagahara N, Li Q, Minami M. New aspects in pathogenesis of Konzo: neural cell damage directly caused by linamarin contained in cassava (Manihot esculenta Crantz). Br J Nutr. 2003;90:467–472
  28. Westley J. Thiosulfate: cyanide sulfur transferase (rhodanese). Meth Enzymol. 1981;77:85–91
  29. Adamolekun B, McCandless DW, Butterworth RF. Epidemic of seasonal ataxia in Nigeria following ingestion of the African silkworm Anaphe venata: role of thiamine deficiency?. Metab Brain Dis. 1997 Dec;12(4):251–258
  30. McCandless DW. African seasonal ataxia. In:  McCandless DW editors. Thiamine deficiency and associated clinical disorders. NY: Humana press; 2009;p. 103–112
  31. Barclay DV, Mauron J, Blondel A, Cavadini C, Vereilghen AM, Van Geert , et al. Micronutrient intake and status in rural Democratic Republic of Congo. Nutr Res. 2003;3:659–671
  32. Green RG, Carlson WE, Evans CA. A deficiency disease of foxes produced by feeding fish. J Nutr. 1941;21:243–356
  33. Yudkin WH. Thiaminase, the Chastek-paralysis factor. Physiol Rev. 1949;388–402
  34. Read DH, Jolly RD, Alley MR. Polioencephalomalacia of dogs with thiamine deficiency. Vet Pathol. 1977;14(2):103–112
  35. Loew FM, Bettany JM, Halifax CE. Apparent thiamine status of cattle and its relationship to polioencephalomalacia. Can J Comp Med. 1975;39:291–295
  36. Umoh IB, Ogunkoya FO, Maduagwu EN, Oke OL. Effect of thiamine status on the metabolism of linamarin. Ann Nutr Metab. 1985;29:319–324
  37. Macias-Matos C, Rodriguez-Ojea A, Chi N, et al. Biochemical evidence of thiamine depletion during the Cuban Neuropathy Epidemic, 1992–1993. Am J Clin Nutr. 1996;64:347–353
  38. Roman GC. On politics and health: an epidemic of neurologic disease in Cuba. Ann Intern Med. 1995;1:530–533
  39. Mwanza JC, Lysebo DE, Kayembe DL, Tshala-katumbay D, Nyamabo LK, Tylleskar T, et al. Visual evoked potentials in Konzo, a spastic paraparesis of acute onset in Africa. Ophthalmologica. 2003;217(6):81–86
  40. Mwanza JC, Tshala-katumbay D, Kayembe DL, Eeg-Olofsson KE, Tylleskar T. Neuro-ophthalmologic findings in Konzo, an upper motor neurone disorder in Africa. Eur J Ophthalmol. 2003;13(4):383–389
  41. Hoyt CS, Billson FA. Vision loss on low carb diets. Low carbohydrate diet optic neuropathy. Med J Aust. 1997;1:65
  42. Rodger FC. Experimental thiamine deficiency as a cause of degeneration in the visual pathway of the rat. Br J Ophthalmol. 1953;37:11–17
  43. Dang CV. Tobacco-alcohol amblyopia: a proposed biochemical basis for pathogenesis. Med Hypotheses. 1981;7:1317–1328
  44. Lessel S. Experimental cyanide optic neuropathy. Arch Ophthalmol. 1971;86:194–204
  45. Tshala-Katumbay D, Eeg-Olofsson K, Kazadi-Kayembe F, Fallmar P, Tylleskar T, Kayembe-Kalula T. Abnormalities of somatosensory evoked potentials in Konzo—an upper motor neuron disorder. Clin Neurophysiol. 2002;113(1):10–15
  46. World Health Organization . Thiamine deficiency and its prevention and control in major emergencies. WHO/NHD/99.13. 1999;
  47. Katumbay DT, Lukusa VM, Eeg-Olofsson KE. EEG findings in Konzo: a spastic para/tetraparesis of acute onset. Clin Electroencephalogr. 2000;31(4):196–200
  48. Adamolekun B. Thiamine deficiency and the etiology of tropical ataxic neuropathy. Int Health. 2010;2(1):17–21
  49. Swank Rl, Bessey OA. Avian thiamine deficiency. Characteristic symptoms and their pathogenesis. J Nutr. 1941;22:77–89

PII: S0022-510X(10)00286-8

doi: 10.1016/j.jns.2010.06.016

Journal of the Neurological Sciences
Volume 296, Issue 1 , Pages 30-33 , 15 September 2010

Article Tools