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Tropical myeloneuropathies

The hidden endemias

Texas Tech University Health Sciences Center School of Medicine (Dr. Román), Lubvock, TX; the Institute of Neurotoxicology, Albert Einstein College of Medicine (Dr. Spencer), Bronx, NY; and the Neuroepidemiology Branch. Intramural Research Program, National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health (Dr. Schoenberg), Bethesda, MD.

Tropical myeloneuropathies include tropical ataxic neuropathy and tropical spastic paraparesis. These disorders occur in geographic isolates in several developing countries and are associated with malnutrition, cyanide intoxication from cassava consumption, tropical malabsorption (TM), vegetarian diets, and lathyrism. TM-malnutrition was a probable cause of myeloneuropathies among Far East prisoners of war in World War 11. Clusters of unknown etiology occur in India, Africa, the Seychelles, several Caribbean islands, Jamaica, and Colombia. Treponemal infection (yaws) could be an etiologic factor in the last two. Tropical myeloneuropathies, a serious health problem, are multifactorial conditions that provide unsurpassed opportunities for international cooperation and neurologic research.

Address correspondence and reprint requests to Dr. Román, Department of Medical and Surgical Neurology, Texas Tech University HSC, School of Medicine, Lubbock, TX 79430.

Accepted for publication November 30, 1984.

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