LONG-TERM FOLLOW-UP OF KONZO PATIENTS

Nine patients with konzo, a symmetric spastic paraparesis of acute ons et that occurs during agricultural crises in cassava-growing areas, we re re-examined after 14 years. Konzo outbreaks are associated with eat ing insufficiently processed bitter cassava and a low intake of essent ial amino acids. Bitter cassava contains cyanogenic glycosides; proces sing breaks them down to acetone cyanohydrin and hydrogen cyanide. Thi s long term follow-up showed that the neurological signs in konzo pati ents remained constant. Four severely affected patients, however, show ed 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.