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Myelopathy caused by nitrous oxide toxicity

P J Pema1, H A Horak, R H Wyatt

  • 1Department of Radiology, Ohio State University Medical Center, Columbus, USA.

AJNR. American Journal of Neuroradiology
|June 5, 1998
PubMed
Summary

Nitrous oxide abuse can cause myeloneuropathy by inactivating vitamin B12. This spinal cord syndrome, visible on MRI, may also affect patients with borderline vitamin B12 levels after anesthesia.

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Area of Science:

  • Neurology
  • Toxicology
  • Radiology

Background:

  • Nitrous oxide (N2O) is an anesthetic agent with potential neurotoxic effects.
  • Substance abuse involving nitrous oxide is a growing concern.
  • Vitamin B12 deficiency can lead to neurological complications.

Observation:

  • A case study detailing myeloneuropathy secondary to nitrous oxide abuse.
  • Magnetic resonance (MR) imaging findings of the cervical spinal cord.
  • Symmetric abnormal signal intensity in the posterior columns of the cervical cord.

Findings:

  • Nitrous oxide inactivates vitamin B12, leading to myeloneuropathy.
  • The observed MR imaging findings are consistent with vitamin B12 inactivation.
  • This neurological syndrome can manifest in individuals with pre-existing borderline vitamin B12 deficiency exposed to nitrous oxide.

Implications:

  • Highlights the neurotoxic potential of nitrous oxide abuse.
  • Emphasizes the importance of considering vitamin B12 status in patients with neurological symptoms after N2O exposure.
  • Suggests the need for increased awareness and diagnostic vigilance for nitrous oxide-induced myeloneuropathy.

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