Nitrous Oxide-induced Myeloneuropathy Due to Recreational Abuse.


Journal

The Israel Medical Association journal : IMAJ
ISSN: 1565-1088
Titre abrégé: Isr Med Assoc J
Pays: Israel
ID NLM: 100930740

Informations de publication

Date de publication:
May 2024
Historique:
medline: 13 5 2024
pubmed: 13 5 2024
entrez: 13 5 2024
Statut: ppublish

Résumé

The recreational use of nitrous oxide (N2O) has increased in recent years with a noticeable surge in the incidence of nitrous oxide-related myeloneuropathy. To raise awareness of increasing myeloneuropathy due to recreational nitrous oxide misuse in Israel. We conducted a case series documenting the clinical and investigative features of eight patients presenting with nitrous oxide-induced myeloneuropathy who were admitted to our departments. Paresthesia was the chief complaint in all patients, with sensory gait ataxia being a common feature, which was often accompanied by Romberg's sign and mild lower limb weakness. Vitamin B12 levels were below the normal range in seven patients, accompanied by elevated homocysteine and methylmalonic acid levels. Magnetic resonance imaging scans revealed hyperintense signals in the dorsal columns of the cervical spine. All patients improved following vitamin B12 injections. Enhancing awareness, prompting the use of appropriate investigations, and advocating for timely treatment are needed to overcome the risks associated with nitrous oxide misuse.

Sections du résumé

BACKGROUND BACKGROUND
The recreational use of nitrous oxide (N2O) has increased in recent years with a noticeable surge in the incidence of nitrous oxide-related myeloneuropathy.
OBJECTIVES OBJECTIVE
To raise awareness of increasing myeloneuropathy due to recreational nitrous oxide misuse in Israel.
METHODS METHODS
We conducted a case series documenting the clinical and investigative features of eight patients presenting with nitrous oxide-induced myeloneuropathy who were admitted to our departments.
RESULTS RESULTS
Paresthesia was the chief complaint in all patients, with sensory gait ataxia being a common feature, which was often accompanied by Romberg's sign and mild lower limb weakness. Vitamin B12 levels were below the normal range in seven patients, accompanied by elevated homocysteine and methylmalonic acid levels. Magnetic resonance imaging scans revealed hyperintense signals in the dorsal columns of the cervical spine. All patients improved following vitamin B12 injections.
CONCLUSIONS CONCLUSIONS
Enhancing awareness, prompting the use of appropriate investigations, and advocating for timely treatment are needed to overcome the risks associated with nitrous oxide misuse.

Identifiants

pubmed: 38736344

Substances chimiques

Nitrous Oxide K50XQU1029
Vitamin B 12 P6YC3EG204

Types de publication

Journal Article Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

294-298

Auteurs

Ron Dabby (R)

Department of Neurology, Wolfson Medical Center, Holon, Israel, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Diana Paleacu Kertesz (D)

Abarbanel Mental Health Center, Bat Yam, Israel.

Ilia Demurchev (I)

Department of Neurology, Wolfson Medical Center, Holon, Israel.

Oded Hershkovich (O)

Department of Orthopedic Surgery, Wolfson Medical Center, Holon, Israel, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Mira Ginsberg (M)

Pediatric Neuromuscular Clinic and Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel.

Menachem Sadeh (M)

Department of Neurology, Wolfson Medical Center, Holon, Israel, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

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Classifications MeSH