The present review covers the history of the neurotoxic effect of palmyrah (Borassus flabellifer L). The chemical nature of the active synergists is isomers of a spirostane tetraglycoside containing three rhamnosyl residues and one glucosamine where the position of the NH(2) appears to be the difference in the saponins. As neurotoxicity has not been reported in humans consuming palmyrah flour, it is hypothesized that this may be due to one or more of the following: a species effect; the mode of processing flour and cooking palmyrah flour recipes containing these water-soluble and dry-heat decomposable saponin primary amines; frequency of consumption of palmyrah flour-based products; and the nutritive value of other dietary components. It is hypothesized that the Hepatotoxic syndrome as reported previously is due to a collective effect of a number of biologically active compounds, most of which are water-soluble saponins, like neurotoxins.