Assuntos
Surtos de Doenças , Manihot/efeitos adversos , Paraparesia Espástica/epidemiologia , Adolescente , Criança , Transtornos da Nutrição Infantil/epidemiologia , Pré-Escolar , Comorbidade , Estudos Transversais , Cianetos/urina , República Democrática do Congo/epidemiologia , Países em Desenvolvimento , Dieta , Escolaridade , Feminino , Habitação , Humanos , Lactente , Transtornos da Nutrição do Lactente/epidemiologia , Masculino , Manihot/química , Paraparesia Espástica/economia , Paraparesia Espástica/etiologia , Paraparesia Espástica/psicologia , Paraparesia Espástica/urina , Pobreza , Índice de Gravidade de Doença , Fatores Socioeconômicos , Superstições , Tiocianatos/urinaRESUMO
To elucidate the involvement of motor pathways in konzo, 21 konzo subjects (mean age 22 years) underwent transcranial electrical stimulation (TES) in 1998. Fourteen konzo subjects (mean age 21 years) underwent transcranial magnetic stimulation (TMS) in 2000. Three subjects underwent both TES and TMS. Motor evoked potentials (MEPs) were recorded in the abductor pollicis brevis (APB) muscle with TES, and in the abductor digiti minimi (ADM) and tibialis anterior (TA) muscles with TMS. APB-MEPs were normal in 2 of 21 subjects and absent in 9; central conduction time (CCT) was prolonged in 10. Resting ADM-MEPs were absent in 9 of 14 subjects with clinically preserved upper limbs. Among these nine, seven subjects responded after facilitation. Most subjects (13 of 14) failed to show TA-MEPs. Of the subjects who underwent both types of stimulation, one had normal TES-MEP but abnormal ADM-MEP with TMS. These findings suggest involvement of both corticomotoneurons and motor descending pathways in konzo.
