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Recreational Nitrous Oxide-Induced Subacute Combined Degeneration
Yetunde B Omotosho1, Grace W Ying2, Richard Orji2
1Internal Medicine, The Chicago Medical School Internal Medicine Residency Program at Northwestern Mchenry Hospital, McHenry, USA.
Cureus
|April 27, 2022
Summary
Recreational nitrous oxide abuse can cause vitamin B12 deficiency, leading to subacute combined degeneration (SCD). Early diagnosis and B12 treatment are crucial for preventing permanent nerve damage.
Area of Science:
- Neurology
- Toxicology
- Nutritional Science
Background:
- Subacute combined degeneration (SCD) is a myelopathy resulting from vitamin B12 deficiency, affecting the posterior spinal cord.
- Recreational nitrous oxide (N2O) use is prevalent but its neurotoxic effects, including nerve dysfunction, are often underestimated.
Observation:
- A 32-year-old male presented with paresthesia and lower extremity weakness.
- The patient was diagnosed with vitamin B12 deficiency attributed to chronic nitrous oxide abuse.
Findings:
- The patient showed positive response to intramuscular vitamin B12 supplementation.
- Elevated methylmalonic acid (MMA) levels confirmed vitamin B12 deficiency.
Implications:
- Clinicians should consider nitrous oxide abuse in patients with suspected vitamin B12 deficiency and myeloneuropathy.
- Prompt diagnosis and treatment of B12 deficiency can reverse neurological symptoms and prevent further nerve damage.
