Myelopathy and polyneuropathy caused by nitrous oxide toxicity: a case report
| Autor: | Yue-quen Chen, Sheng-Chuan His, Huan-Chu Lo, Hann-Yeh Shyu, Vei-zen Lung, Chih-kang Hsu |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Inhalant Abuse Nitrous Oxide Physical examination Nerve conduction velocity Spinal Cord Diseases Myelopathy Polyneuropathies Young Adult Medicine Outpatient clinic Humans medicine.diagnostic_test business.industry Recreational use of nitrous oxide Steppage gait Sensory loss General Medicine medicine.disease Surgery Vitamin B 12 Anesthesia Vitamin B Complex Emergency Medicine business Emergency Service Hospital Polyneuropathy |
| Zdroj: | The American journal of emergency medicine. 30(6) |
| ISSN: | 1532-8171 |
| Popis: | A 19-year-old man presented with a 1-month history of progressive 4-limb numbness and gait imbalance. Physical examination revealed mild general muscular weakness, areflexia, and wide-based, ataxic, steppage gait. Sensory tests showed diminished superficial sensation below the level of the cervical-thoracic junction and a glove-and-stocking pattern of sensory loss at the 4 extremities. An initial magnetic resonance imaging examination of the cervical spine revealed an increased bilateral signal from the posterior and anterior columns on T 2 -weighted images. Nerve conduction velocity and electromyographic tests revealed polyneuropathy. On further inquiry, the patient admitted to chronic recreational use of nitrous oxide. The final diagnosis was nitrous oxide–induced neurotoxicity. The patient was treated for 5 days with injections of 1000 μ g/day vitamin B 12 , followed by an additional 2-month treatment at a dose of 1000 μ g/week. The numbness resolved after the first week, but there remained a mild sensory ataxic gait. The patient recovered fully after 2 months of treatment and nitrous oxide abstinence. We recommend an investigation of the patient's history of nitrous oxide exposure in cases where an individual presents to the emergency department or outpatient department with acute numbness characterized by megaloblastic red blood cells and symmetric neurologic deficits. |
| Databáze: | OpenAIRE |
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