Endemoepidemic neurodegenerative diseases putatively caused by food toxins have been reported around the globe with no clear understanding of their pathogenetic mechanisms. These diseases include the amyotrophic lateral sclerosis/parkinsonism dementia complex among the Guamanians; neurolathyrism among Europeans, Indians, and populations of the Horn of Africa; and tropical ataxic neuropathy or konzo among sub-Sahara Africans.1,2 We focus on the molecular determinants of susceptibility to konzo, a poorly known self-limited and irreversible upper motor neuron disease (spastic paraparesis) highly prevalent in Congo-Kinshasa, Mozambique, Tanzania, Central African Republic, Angola, and Cameroon. The main clinical picture consists of a symmetrical, permanent, and irreversible spastic paraparesis with no signs of sensory or genitourinary impairments.2,3 Severely affected individuals may present with a tetraparesis and pseudobulbar signs. The disease konzo was named after a fetish used by the “Yaka” population of Congo-Kinshasa. The World Health Organization has adopted the following epidemiologic criteria for the disease: 1) an abrupt onset (<1 week) of weakness in legs and a nonprogressive course of the disease in a formerly healthy person, 2) a symmetrical spastic abnormality when walking and/or running, and 3) bilaterally exaggerated knee and/or ankle jerks without signs of disease of the spine.