Neurological Zebras: Lathyrism

There’s a book by Jon Krakauer (and now a movie) titled, “Into the Wild”. It’s about Chris McCandless, a 24 year-old man who went off the grid and into the wilds of Alaska:

In April 1992 a young man from a well-to-do family hitchhiked to Alaska and walked alone into the wilderness north of Mt. McKinley. His name was Christopher Johnson McCandless. He had given $25,000 in savings to charity, abandoned his car and most of his possessions, burned all the cash in his wallet, and invented a new life for himself. Four months later, his decomposed body was found by a moose hunter.

It had never been established exactly why Mr. McCandless died. There is an entry in his journal that reads, “EXTREMELY WEAK. FAULT OF POT[ATO] SEED. MUCH TROUBLE JUST TO STAND UP. STARVING. GREAT JEOPARDY.” (Emphasis added). If a toxic exposure was indeed his problem, was he simply eating a plant that he should not have? This seemed unlikely because Mr. McCandless was reportedly a very knowledgeable survivalist.

A writer and former university professor named R. C. Hamilton may have solved the mystery. He recognized from the description of Mr. McCandless’s illness a similarity to the plight of the captives in an obscure Nazi concentration camp in Romania called Vapniarca. The captives were intentionally fed “pea fodder”, Lathurus sativus, and many developed lathyrism. Lathyrism causes myelopathy. It is thought to be due to excitotoxicity of beta-N-oxalyl-L-alpha-beta-diaminoproprionic acid (called ODAP) at AMPA receptors. Mr. Hamilton enlisted the help of some scientists to determine that the potato seeds Mr. McCandless was eating indeed contained ODAP.

The paper above is fascinating for the detective work described, the brief history of lathyrism (which goes back thousands of years) and especially for the story of an official at Vapniarca who was sympathetic to the plight of the captives there and who, at the behest of a Jewish doctor who diagnosed lathyrism in his co-captives, was able to end the practice of feeding them pea fodder.

Another interesting read about all of this, and where I found the link to Hamilton’s paper, is a New Yorker piece by Jon Krakauer, the author of “Into the Wild”, who goes into more detail about his own attempts to solve this mystery and credits Hamilton with finally solving it.

Now, I haven’t read “Into the Wild” and certainly can’t verify the scientific validity of Mr. Hamilton’s and Mr. Krakauer’s findings (actually, the findings of the scientists they asked to investigate the issue). I don’t know whether Mr. McCandless’s body was autopsied or whether spinal cord sections were included that might corroborate the presence of a toxic myelopathy. But with all of those caveats, the linked articles are some very interesting reads!

About Justin A. Sattin

I'm a vascular neurologist and residency program director. I created this blog in order to share some thoughts with my resident and other colleagues, and to foster my own learning as well.
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One Response to Neurological Zebras: Lathyrism

  1. Khalid says:

    this is really amazing to start with… but whats more interesting and funny at the same time is that 5 minutes before you sent the link i was learning and reading about 2 new causes of myelopathy that i’ve never read about until i had this question in the board review book . Lathyrism and Konzo !!!
    – Lathyrism : it seems its endemic in Ethiopia , indea and Bangladesh from consumption of grass pea or chick pea that contains the toxin, its usually in poor population .
    – Konzo : in africa mainly poor population with consumption of poorly processed Cassava which has cyanide, which cause acute myelopathy with visual impairment.

    so ,,, i hope these questions dont make there way to the boards ….

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