Plants with neurotoxic potential in undernourished subjects

Rev Neurol (Paris). 2019 Dec;175(10):631-640. doi: 10.1016/j.neurol.2019.07.015. Epub 2019 Sep 18.


The consumption by humans of plants with potential to induce neurological disorders is widespread, but overt disease surfaces only when the subject's toxic threshold is exceeded. Excessive intake arising from food dependency in the setting of hunger, chronic undernutrition, vitamin deficiency, inadequate detoxication, or other individual susceptibility, can trigger acute encephalopathy (lychee, ackee fruits), sub-acute spastic paraparesis (grasspea, cassava root/leaves) or ataxic neuropathy (cassava root flour). While these disorders are very rarely encountered in high-income countries, they are not only common among impoverished populations but also often occur as outbreaks that impact a significant proportion of an affected community. Unfamiliarity with the adverse effects of plant toxins has sometimes led to the mistaken attribution of nutritional neurotoxic disease to a neurotropic viral or synthetic pesticidal etiology. The combination of human population growth, food and water insecurity, poverty and, with climate change, increased dependency on environmentally tolerant plants with neurotoxic potential, predictably may result in an increased prevalence of nutritional neurotoxic disorders, especially in certain parts of Africa and Asia.

Keywords: Ackee; Cassava; Global public health; Grasspea; Lychee; Malnutrition; Tropical neurology.

Publication types

  • Review

MeSH terms

  • Blighia / adverse effects
  • Disease Susceptibility
  • Humans
  • Litchi / adverse effects
  • Malnutrition / complications*
  • Malnutrition / epidemiology
  • Manihot / adverse effects
  • Manihot / toxicity
  • Nervous System Diseases / chemically induced*
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology
  • Neurotoxicity Syndromes / epidemiology
  • Neurotoxicity Syndromes / etiology*
  • Plant Poisoning / complications
  • Plant Poisoning / epidemiology
  • Plants / toxicity*
  • Poverty Areas

Supplementary concepts

  • Jamaican vomiting sickness