An outbreak of spastic paralysis affecting the lower limbs is reported among rural families consuming large amounts of a locally grown pulse during a famine year. Affected individuals show a characteristic extensor plantar response with brisk knee jerks but absent ankle jerks. The toxin responsible for this condition is:

• A Agaritine present in wild mushrooms
• B Saxitoxin accumulated in freshwater shellfish
• C Ciguatoxin concentrated in large reef fish
• D Beta-N-oxalylaminoalanine (BOAA) present in Lathyrus sativus ✓

Explanation

Neurolathyrism results from prolonged heavy consumption of kesari dal (Lathyrus sativus, grass pea). The excitatory neurotoxin BOAA (beta-N-oxalylaminoalanine, also called ODAP) damages upper motor neurons, producing irreversible spastic paraplegia with characteristic signs: brisk knee jerks, ankle clonus early, absent ankle jerks later. It occurs mainly in adult men during famine when the pulse forms a large proportion of the diet. Marine toxins are irrelevant distractors from a different category of food-borne disease.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.