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BMC Neurology

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Open Access 01-12-2017 | Case report

Nitrous oxide induced subacute combined degeneration with longitudinally extensive myelopathy with inverted V-sign on spinal MRI: a case report and literature review

Authors: Jun Liang Yuan, Shuang Kun Wang, Tao Jiang, Wen Li Hu

Published in: BMC Neurology | Issue 1/2017

Abstract

Background

Nitrous oxide (N2O), a long-standing anesthetic, is also neurotoxic by interfering with the bioavailability of vitamin B12 if abused. A few case studies have reported the neurological and psychiatric complications of N2O.

Case presentation

Here, we reported a patient of N2O induced subacute combined degeneration (SCD) with longitudinally extensive myelopathy with inverted V-sign exhibiting progressive limb paresthesia and unsteady gait.

Conclusions

This case raises the awareness of an important mechanism of neural toxicity of N2O, and clinical physicians should be well recognized this in the field of substance-related disorders.

Garakani A, Jaffe RJ, Savla D, Welch AK, Protin CA, Bryson EO, et al. Neurologic, psychiatric, and other medical manifestations of nitrous oxide abuse: a systematic review of the case literature. Am J Addict. 2016;25:358–69.CrossRefPubMed

Mancke F, Kaklauskaite G, Kollmer J, Weiler M. Psychiatric comorbidities in a young man with subacute myelopathy induced by abusive nitrous oxide consumption: a case report. Subst Abuse Rehabil. 2016;7:155–9.CrossRefPubMedPubMedCentral

Garakani A, Welch AK, Jaffe RJ, Protin CA, McDowell DM. Psychosis and low cyanocobalamin in a patient abusing nitrous oxide and cannabis. Psychosomatics. 2014;55:715–9.CrossRefPubMed

Hathout L, El-Saden S. Nitrous oxide-induced B(1)(2) deficiency myelopathy: perspectives on the clinical biochemistry of vitamin B12. J Neurol Sci. 2011;301:1–8.CrossRefPubMed

Ernst LD, Brock K, Barraza LH, Davis A, Nirenberg MJ. Longitudinally extensive nitrous oxide Myelopathy with novel radiographic features. JAMA Neurol. 2015;72:1370–1.CrossRefPubMed

Smith AD, Refsum H. Homocysteine, B Vitamins, and cognitive impairment. Annu Rev Nutr. 2016;36:211–39.CrossRefPubMed

Sotirchos ES, Saidha S, Becker D. Neurological picture. Nitrous oxide-induced myelopathy with inverted V-sign on spinal MRI. J Neurol Neurosurg Psychiatry. 2012;83:915–6.CrossRefPubMed

Title: Nitrous oxide induced subacute combined degeneration with longitudinally extensive myelopathy with inverted V-sign on spinal MRI: a case report and literature review
Authors: Jun Liang Yuan
Shuang Kun Wang
Tao Jiang
Wen Li Hu
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2017
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-017-0990-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Nitrous oxide induced subacute combined degeneration with longitudinally extensive myelopathy with inverted V-sign on spinal MRI: a case report and literature review

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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