The case of a 22-year-old Nigerian detainee with features of severe clinical malnutrition, is reported. Within 2 years of prison confinement and undernutrition, he developed features of severe malnutrition, with severe sensory and motor neuropathy of the lower limbs, and pulmonary tuberculosis. Despite intensive nutritional rehabilitation, patient did not regain the use of his lower limbs. The initial economic constraint in the management is highlighted.