Nitrous oxide myelopathy with functional vitamin B deficiency
John Williamson1, Saif Huda1, Dinesh Damodaran1
1Department of Neurology, The Walton Centre Foundation NHS Trust, Liverpool, UK.
BMJ Case Reports
|February 16, 2019
Summary
Recreational nitrous oxide misuse can cause severe neurological damage, specifically myelopathy. Prompt vitamin B12 replacement can reverse these effects, highlighting the importance of awareness among healthcare providers.
Area of Science:
- Neurology
- Toxicology
- Medical Research
Background:
- Recreational nitrous oxide (N2O) use, often as a 'legal high', is rising in the UK.
- Physicians need awareness of N2O's increasing prevalence and associated neurological risks.
- Nitrous oxide misuse can lead to significant neurological complications.
Observation:
- A 17-year-old male presented with severe myelopathy.
- The patient reported prolonged recreational nitrous oxide use.
- Neurological symptoms were linked to N2O misuse.
Findings:
- Magnetic Resonance Imaging (MRI) revealed characteristic changes in the dorsal columns.
- Blood tests indicated a functional vitamin B12 deficiency.
- These findings correlate N2O misuse with vitamin B12 deficiency and myelopathy.
Implications:
- Early recognition of N2O-induced neurological complications is crucial.
- Vitamin B12 replacement therapy can lead to clinical and radiological recovery.
- This case underscores the need for physician education on recreational drug use and its neurological sequelae.
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