The WHO has recommended three criteria for the diagnosis of<unk> : * a visible symmetric spastic abnormality of gait while walking or running; * a history of onset of less than one week followed by a non-progressive course in a formerly healthy person; * bilaterally exaggerated knee or ankle jerk reflexes without signs of disease of the spine. Depending on its severity,<unk>  is divided into three categories: mild when individuals are able to walk without support, moderate when individuals need one or two sticks to walk, and severe when the affected person is unable to walk unsupported. Differential diagnosis The clinical symptoms are strikingly similar to those of lathyrism and also similar to tropical spastic paraparesis and hereditary spastic paraparesis, only that the latter two disorders have a slow onset.<unk>  is distinct from polio which is a flaccid paralysis and most often affects a person asymmetrically.<unk>  is one of several tropical neuropathies. A distinct myeloneuropathy also associated to cyanogen intake from cassava is tropical ataxic neuropathy (TAN), as first described in parts of Nigeria by B. O. Osuntokun in 1968. The disease is still occurring in the same areas.
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