破解鞭子:由于慢性氧化滥用而导致的肌神经病的不一致治疗
1Emergency Department, Queen Elizabeth Hospital Birmingham, Birmingham, GBR.
Cureus
|February 26, 2024
概括
娱乐性氧化 (N2O) 滥用会通过耗尽维生素B12造成严重的神经损伤. 这项研究强调了N2O神经毒性治疗方法的多样性,表明缺乏对这个日益增长的问题进行标准化的护理.
科学领域:
- 神经学 神经学
- 毒理学 毒理学 毒理学
- 营养神经科学 营养神经科学
背景情况:
- 对氧化 (N2O) 的娱乐性滥用是全球日益关注的问题.
- 慢性N2O滥用可能导致神经损伤,包括神经和脊髓损伤,由于维生素B12的不活化.
研究的目的:
- 介绍六个因N2O滥用而导致的神经并发症的病例.
- 分析N2O诱导的神经毒性的诊断方法和治疗方案.
主要方法:
- 关于伯明翰伊丽莎白女王医院 (2016-2020) 神经病学入院的回顾性审查.
- 纳入标准:神经功能障碍 (神经病变/骨髓病变) 和慢性N2O滥用.
- 收集的数据:人口统计,N2O使用,症状,血液测试 (MMA,同类素),神经导电研究和治疗方案.
主要成果:
- 六名男性患者 (22-28岁) 因N2O"鞭子"滥用而出现感觉和运动障碍.
- 诊断依赖于临床怀疑,N2O史,高MMA/homocysteine,以及神经传导研究.
- 亲肠道维生素B12的治疗在路线,剂量和持续时间上有显著的变化,使用叶酸是不一致的.
结论:
- 在N2O神经毒性管理方面存在显著的变异性.
- 目前的维生素B12替代治疗方案缺乏标准化.
- 需要进一步的研究,以建立共识指导方针来管理N2O诱导的神经并发症.
相关概念视频
Myasthenia Gravis: Overview and Treatment
1.4K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.4K
Skeletal Muscle Relaxants: Therapeutic Uses
486
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
486
Drugs Acting on Autonomic Ganglia: Stimulants
1.3K
Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
1.3K
Anticholinesterase Agents: Poisoning and Treatment
856
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
856
Skeletal Muscle Relaxants: Adverse Effects
372
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
372
Myasthenia Gravis: Diagnostic Tests
840
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
840


