Historique
Article de Périodique
Recreational nitrous oxide abuse related subacute combined degeneration of the spinal cord in adolescents - A case series and literature review (2019)
Auteur(s) :
LAN, S. Y. ;
KUO, C. Y. ;
CHOU, C. C. ;
KONG, S. S. ;
HUNG, P. C. ;
TSAI, H. Y. ;
CHEN, Y. C. ;
LIN, J. J. ;
CHOU, I. J. ;
LIN, K. L.
Année
2019
Page(s) :
428-435
Sous-type de document :
Etude de cas / Case report ; Revue de la littérature / Literature review
Langue(s) :
Anglais
Refs biblio. :
39
Domaine :
Autres substances / Other substances
Discipline :
PAT (Pathologie organique / Organic pathology)
Thésaurus mots-clés
PROTOXYDE D'AZOTE
;
USAGE RECREATIF
;
ADOLESCENT
;
MOELLE EPINIERE
;
VITAMINES
;
CARENCE
;
ETUDE DE CAS
;
PATHOLOGIE ORGANIQUE
;
TOXICITE
Résumé :
Background: Nitrous oxide (N2O) is a commonly used inhaled anesthetic in outpatient dental procedures. However, the increasing recreational use of N2O may result in vitamin B12 deficiency-related neurologic and psychiatric symptoms. The aim of this study was to demonstrate the clinical features of chronic N2O abuse in pediatric patients.
Methods: Patients under 20 years of age who were diagnosed with N2O-induced subacute combined degeneration of the spinal cord from 2012 to 2018 were enrolled in this study. Clinical presentations, laboratory, imaging, ancillary studies, treatments and outcomes were analyzed.
Results: Nine patients were included, all of whom presented with symptoms of myeloneuropathy including limb numbness, limb weakness or unsteady gait. Six patients had low or low-normal vitamin B12 (cyanocobalamin) levels. Eight patients had evidence of subacute combined degeneration of the spinal cord via neuroimaging studies. All of the patients received vitamin B12 supplementation as treatment. All had full recovery of muscle power within 2?months. Five patients had persistent sensory deficits.
Conclusion: Chronic N2O abuse can cause permanent neurological damage if not treated promptly. Clinical staff should be aware of the various presentations of neurotoxicity related to N2O abuse.
Methods: Patients under 20 years of age who were diagnosed with N2O-induced subacute combined degeneration of the spinal cord from 2012 to 2018 were enrolled in this study. Clinical presentations, laboratory, imaging, ancillary studies, treatments and outcomes were analyzed.
Results: Nine patients were included, all of whom presented with symptoms of myeloneuropathy including limb numbness, limb weakness or unsteady gait. Six patients had low or low-normal vitamin B12 (cyanocobalamin) levels. Eight patients had evidence of subacute combined degeneration of the spinal cord via neuroimaging studies. All of the patients received vitamin B12 supplementation as treatment. All had full recovery of muscle power within 2?months. Five patients had persistent sensory deficits.
Conclusion: Chronic N2O abuse can cause permanent neurological damage if not treated promptly. Clinical staff should be aware of the various presentations of neurotoxicity related to N2O abuse.
Affiliation :
Department of Pediatric Neurology, Saint Paul’s Hospital, Taoyuan, Taiwan