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Funicular myelosis in a butcher: it was the cream cans

Fabian Wolpert1, Krisztina Baráth2, Janis Brakowski3

  • 1Department of Neurology, University Hospital Zürich, Frauenklinikstrasse 26, 8091 Zürich, Switzerland.

Case Reports in Neurological Medicine
|February 20, 2015
PubMed

Insights

Nitrous oxide abuse can cause funicular myelosis, even with high vitamin B12 intake. Patients with vitamin B12 deficiency should be screened for nitrous oxide abuse.

Area of Science:

  • Neurology
  • Toxicology
  • Nutritional Science

Background:

  • Funicular myelosis is a known neurological complication of nitrous oxide exposure.
  • Limited research exists on long-term effects and vitamin B12 supplementation in nitrous oxide abuse.
  • Nutritional vitamin B12 intake may not counteract nitrous oxide's detrimental effects.

Purpose of the Study:

  • To report a case of funicular myelosis due to recreational nitrous oxide abuse.
  • To highlight the potential inefficacy of nutritional vitamin B12 in preventing or treating this condition.
  • To emphasize the importance of considering nitrous oxide abuse in patients with vitamin B12 deficiency.

Main Methods:

  • Case report of a young male diagnosed with funicular myelosis.
  • Exclusion of other metabolic causes for the myelosis.
  • Identification of recreational nitrous oxide abuse via whipped cream canisters.
  • Treatment with cessation of abuse and vitamin B12 supplementation.

Main Results:

  • Diagnosis of funicular myelosis in a patient with high meat consumption.
  • Discovery of underlying recreational nitrous oxide abuse.
  • Significant clinical recovery after discontinuing nitrous oxide and initiating vitamin B12 therapy.

Conclusions:

  • High nutritional vitamin B12 intake was insufficient to prevent funicular myelosis from nitrous oxide abuse.
  • Increasing nitrous oxide misuse necessitates consideration in clinical diagnosis and treatment.
  • Assessment for nitrous oxide abuse is crucial for patients presenting with vitamin B12 deficiency.

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