Konzo: a nutrition-related tropical spastic paraparesis

Konzo, derived from the Yaka term for 'tired legs' (Democratic Republic of the Congo, DRC) and also known as Buka-buka in the Bandundu region of DRC, is a nutrition-related neurotoxic disorder confined to sub-Saharan Africa. It predominantly affects impoverished and underserved rural populations who depend on bitter cassava as a dietary staple. Cases of konzo most often arise during the dry season or prolonged droughts, when limited water availability hinders adequate soaking or processing of cassava roots, preventing the effective removal of their toxic cyanide content prior to consumption. Clinically, konzo presents as an acute-onset, symmetrical, isolated motor disorder characterised by non-progressive yet permanent spastic paraparesis. In the absence of a curative treatment, the lifelong consequences of konzo impose a substantial burden on affected individuals and their communities.