| Autor: |
Mair, Devan, Paris, Alvar, Zaloum, Safiya A, White, Laura M, Dodd, Katherine C, Englezou, Christina, Patel, Farhin, Abualnaja, Siraj, Lilleker, James B, Gosal, David, Hayton, Tom, Liang, Di, Allroggen, Holger, Pucci, Mark, Keddie, Stephen, Noyce, Alastair J |
| Zdroj: |
Journal of Neurology, Neurosurgery, & Psychiatry (JNNP); 2023, Vol. 94 Issue: 9 p681-688, 8p |
| Abstrakt: |
BackgroundNitrous oxide (N2O) is the second most common recreational drug used by 16- to 24-year-olds in the UK. Neurological symptoms can occur in some people that use N2O recreationally, but most information comes from small case series.MethodsWe describe 119 patients with N2O-myeloneuropathy seen at NHS teaching hospitals in three of the UK’s largest cities: London, Birmingham and Manchester. This work summarises the clinical and investigative findings in the largest case series to date.ResultsParaesthesia was the presenting complaint in 85% of cases, with the lower limbs more commonly affected than the upper limbs. Gait ataxia was common, and bladder and bowel disturbance were frequent additional symptoms. The mid-cervical region of the spinal cord (C3–C5) was most often affected on MRI T2-weighted imaging. The number of N2O canisters consumed per week correlated with methylmalonic acid levels in the blood as a measure of functional B12deficiency (rho (ρ)=0.44, p=0.04).ConclusionsPreventable neurological harm from N2O abuse is increasingly seen worldwide. Ease of access to canisters and larger cylinders of N2O has led to an apparent rise in cases of N2O-myeloneuropathy in several areas of the UK. Our results highlight the range of clinical manifestations in a large group of patients to improve awareness of risk, aid early recognition, and promote timely treatment. |
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