Konzo
| Konzo | |
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| A boy affected by konzo displaying the typical gait. The upper motor neuron is the suspected neurodamage site. | |
| Classification and external resources | |
| Specialty | emergency medicine |
| ICD-10 | T62.2 |
| ICD-9-CM | 988.2 |
Konzo is an epidemic paralytic disease occurring in outbreaks in remote rural areas of low income African countries. The people of these regions have been associated with several weeks of almost exclusive consumption of insufficiently processed "bitter" (high cyanide) cassava (Manihot esculenta)—a perennial crop native to Amazonia in South America, but widely cultivated in tropical regions worldwide. It is the third most important food source in the tropics after rice and maize and is the staple food of tropical Africa. Cassava yields well in poor soils, is drought-resistant, and the roots give food security during droughts and famine. Nutritionally, the starchy roots are complemented by consumption of cassava leaves, which are rich in proteins and vitamins. Konzo was first described by Giovanni Trolli in 1938 who compiled the observations from eight doctors working in the Kwango area of the Belgian Congo (now Democratic Republic of the Congo).
Konzo has been reported in outbreaks mainly among women and children in remote rural populations in DR Congo,Mozambique (where it is known as mantakassa), Tanzania,Central African Republic, Cameroon and Angola.
The first reported outbreak occurred in Bandundu Province in present-day DR Congo in 1936-1937 and the second in Nampula Province of Northern Mozambique in 1981. Each of these outbreaks numbered more than 1000 cases. Familial clustering is common. Outbreaks typically occur in the dry season in households living in absolute poverty that have sustained themselves for weeks or months on insufficiently processed bitter cassava. Both smaller outbreaks and sporadic cases have been reported from all the countries above.
The onset of paralysis (spastic paraparesis) is sudden and symmetrical and affects the legs more than the arms. The resulting disability is permanent but does not progress. Typically, a patient is standing and walking on the balls of the feet with rigid legs and often with ankle clonus.
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