What is a typical clinical course of neurolathyrism?
According to the cited reference, a typical course starts 3-6 months after a diet of 30% of the seeds. Three clinical courses have been described as acute, subacute, and insidious. Most commonly, sudden onset of dramatic bilateral lower extremity weakness (wake up weakness). This presentation is also associated with heavy physical activity. Also described is a subacute presentation of lower extremity weekness preceeded by 2 weeks of lower extremity cramping and muscle aches. The third description is a months long development of paresis and is associated with lumbar aches and thigh pain. Sensory symptoms are rare in all three presentations.
Woldeamanuel YW, Hassan A, Zenebe G. Neurolathyrism: two Ethiopian case reports and review of the literature. J Neurol. 2012 Jul;259(7):1263-8. doi: 10.1007/s00415-011-6306-4. Epub 2011 Nov 12. PMID: 22081101.