KONZO: A NEW HUMAN DISEASE ENTITY

Konzo is a paralytic disease, formerly called epidemic spastic paraparesis, which was first described by Trolli in 1936 in Zaire. During the last decade there has been a number of epidemics of konzo in rural areas of East and Central Africa. These epidemics occur in the dry season among very poor rural populations whose diets for the weeks and months prior to onset consist almost exclusively of roots of bitter cassava. Endemic or sporadic cases also occur in the same areas. The prevalence rate of konzo in affected populations ranges from 1–30 per 1000. Konzo is primarily a disease of children above the age of three, and of women in the fertile age group. The clinical features are characterized by an abrupt onset of a permanent, symmetrical but non-progressive, spastic paraparesis (paralysis of both legs) in a previously healthy person. Associated involvement of the arms and, occasionally, cranial nerves may be present in cases with severe spastic paraparesis. The range of disabilities varies from a slightly spastic gait in mild cases to a complete inability to walk in more severely affected cases. Konzo can be distinguished clinically from the other main tropical myeloneuropathies including tropical ataxic neuropathy (TAN), lathyrism and HTLV-1-associated myelopathy.