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Updated: Jul 15, 2026

Chemiluminescence-based Assays for Detection of Nitric Oxide and its Derivatives from Autoxidation and Nitrosated Compounds
Published on: February 16, 2022
[Nitric-oxide triggered neurological disorders in subjects with vitamin B12 deficiency]
F Cohen Aubart1, F Sedel, S Vicart
1Assistance Publique-Hôpitaux de Paris, Fédération des maladies du Système Nerveux, et Université Pierre et Marie Curie, Groupe Hospitalier Pitié Salpêtrière 47-83 boulevard de l'hôpital 75013 Paris, France.
Introduction:
Nitrous oxide is frequently used for anesthesia. It may cause spinal cord toxicity.
Case Reports:
We report two patients who presented gait disorders after nitrous oxide anesthesia. Physical examination revealed arms and legs pyramidal syndrome and abnormal proprioception, consistent with subacute combined degeneration of the spinal cord. Serum vitamin B12 level was extremely low. The patients improved with parenteral treatment with hydroxycobalamin.
Conclusions:
The inactivation of methionine synthase and L methylmalonylcoA mutase by nitrous oxide has been previously demonstrated. Anesthesia-related exposure to nitrous oxide may induce neurologic disorders even in patients with no preliminary vitamin B12 deficiency.
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