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Paralysis caused by "nagging".

Michaela Cartner1, Michael Sinnott, Peter Silburn

  • 1Prince Charles Hospital, Brisbane, QLD, Australia. michaelajanec@yahoo.com.au

The Medical Journal of Australia
|September 19, 2007
PubMed
Summary
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Nitrous oxide misuse can cause severe spinal cord damage, leading to paralysis. This case highlights the neurological risks of inhaling nitrous oxide, especially with vitamin B12 deficiency.

Area of Science:

  • Neurology
  • Toxicology
  • Nutritional Science

Background:

  • Subacute combined degeneration of the spinal cord is a rare neurological complication.
  • Nitrous oxide (N2O) abuse is an emerging public health concern.
  • Vitamin B12 deficiency is a known cause of myelopathy.

Observation:

  • A young woman presented with acute lower limb paralysis, malnutrition, and dehydration.
  • She reported daily, high-volume nitrous oxide inhalation from whipped-cream bulbs for 10 days.
  • Her medical history included intravenous drug use and a methadone program, with documented low vitamin B12 levels.

Findings:

  • The patient's presentation was consistent with subacute combined degeneration of the spinal cord.
  • Nitrous oxide misuse was identified as the likely cause, exacerbated by malnutrition and vitamin B12 deficiency.

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  • This case underscores the neurotoxic potential of recreational nitrous oxide use.

    • Implications:

    • Highlights the critical need for awareness regarding the neurological risks of nitrous oxide abuse.
    • Emphasizes the importance of screening for vitamin B12 deficiency in patients with neurological symptoms and a history of substance misuse.
    • Suggests that nitrous oxide abuse can lead to irreversible neurological damage, necessitating prompt diagnosis and intervention.