The Last Laugh - Reversible myeloneuropathy induced by chronic nitrous oxide use
1Acute Medical Unit (AMU), University College Hospital, 235 Euston Road, London, NW1 2BU.
Acute Medicine
|March 19, 2019
Summary
Recreational nitrous oxide abuse can cause vitamin B12 deficiency, leading to neurological damage. Prompt abstinence and B12 treatment can result in a full recovery from neuropathy.
Area of Science:
- Neurology
- Toxicology
Background:
- Neurological complications can arise from recreational substance use.
- Vitamin B12 deficiency is a known cause of subacute combined degeneration of the spinal cord.
Observation:
- A 19-year-old male presented with rapidly progressing ataxic-sensory neuropathy.
- Extensive recreational nitrous oxide use was identified as the cause.
- Investigations revealed functional vitamin B12 deficiency.
Findings:
- Nitrous oxide abuse led to subacute combined degeneration of the cord due to vitamin B12 deficiency.
- Neurological symptoms rapidly improved upon cessation of nitrous oxide and vitamin B12 supplementation.
Implications:
- Highlights the importance of considering nitrous oxide abuse in atypical neurological presentations.
- Suggests that early diagnosis and treatment can lead to significant neurological recovery.
- Underscores the neurotoxic potential of recreational nitrous oxide use.
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