NITROUS OXIDE ANAESTHESIA INDUCED VITAMIN B12 DEFICIENCY PRESENTING AS ACUTE MYELONEUROPATHY
Keywords:
Nitrous oxide, Anesthesia, Vitamin B12 deficiency, Myeloneuropathy, Alcohol
Abstract
Nitrous oxide (N2O) can precipitate vitamin B12 (cyanocobalamin) deficiency in susceptible individuals with borderline vitamin stores. We present a case of an alcohol-dependent patient who developed acute neurological symptoms following N2O anesthesia for mandibular surgery. Timely recognition and treatment resulted in complete neurological recovery. N2O induced acute neurological symptoms must be kept as an important differential diagnosis in at-risk patients who undergo surgery under general anesthesia.
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References
1. Lassen HCA, Henricksen E, Neukirch F, Kristensen HS. Treatment of tetanus. Severe bone-marrow depression after prolonged nitrous-oxide anesthesia. Lancet 1956; 1:527-30.
2. Sahenk Z, Mendell JR, Gouri D, Nachtman J. Polyneuropathy from inhalation of N2O cartridges through a whipped cream dispenser. Neurology 1978; 28:485–487.
3. Vishnubhakat SM, Beresford HR. Reversible myeloneuropathy of nitrous oxide abuse: serial electrophysiological studies. Muscle Nerve 1991; 14:22–26.
4. Schilling RF. Is nitrous oxide a dangerous anesthetic for vitamin B12-deficient subjects? JAMA 1986; 255:1605-1606.
5. Kinsella LJ, Green R. Anesthesia paresthetica: nitrous oxide-induced cobalamin deficiency. Neurology 1995; 45(8): 1608-1610.
6. Flippo TS, Holder WD. Neurologic degeneration associated with N2O anesthesia in patients with vitamin B12 deficiency. Archives of Surgery 1993;
128(12):1391-1395.
7. Rosener M, Dichgans J. Severe combined degeneration of the spinal cord after nitrous oxide anesthesia in a vegetarian (letter). J Neurol Neurosurg Psychiatry
1996; 60:354.
8. Timms SR, Cure JK, Kurent JE. Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol 1993; 14:1224–1227.
9. Louis-Ferdinand RT. Myelotoxic, neurotoxic and reproductive adverse effects of nitrous oxide. Adverse Drug React Toxicol Rev 1994; 13:193–206.
10. Healton EB, Savage DG, Brust JCM, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine 1991;7 0:229-245.
2. Sahenk Z, Mendell JR, Gouri D, Nachtman J. Polyneuropathy from inhalation of N2O cartridges through a whipped cream dispenser. Neurology 1978; 28:485–487.
3. Vishnubhakat SM, Beresford HR. Reversible myeloneuropathy of nitrous oxide abuse: serial electrophysiological studies. Muscle Nerve 1991; 14:22–26.
4. Schilling RF. Is nitrous oxide a dangerous anesthetic for vitamin B12-deficient subjects? JAMA 1986; 255:1605-1606.
5. Kinsella LJ, Green R. Anesthesia paresthetica: nitrous oxide-induced cobalamin deficiency. Neurology 1995; 45(8): 1608-1610.
6. Flippo TS, Holder WD. Neurologic degeneration associated with N2O anesthesia in patients with vitamin B12 deficiency. Archives of Surgery 1993;
128(12):1391-1395.
7. Rosener M, Dichgans J. Severe combined degeneration of the spinal cord after nitrous oxide anesthesia in a vegetarian (letter). J Neurol Neurosurg Psychiatry
1996; 60:354.
8. Timms SR, Cure JK, Kurent JE. Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol 1993; 14:1224–1227.
9. Louis-Ferdinand RT. Myelotoxic, neurotoxic and reproductive adverse effects of nitrous oxide. Adverse Drug React Toxicol Rev 1994; 13:193–206.
10. Healton EB, Savage DG, Brust JCM, Garrett TJ, Lindenbaum J. Neurologic aspects of cobalamin deficiency. Medicine 1991;7 0:229-245.
How to Cite
1.
Manish Tyagi, Harshavardhan Sampath, Geeta Soohinda, Sanjiba Dutta. NITROUS OXIDE ANAESTHESIA INDUCED VITAMIN B12 DEFICIENCY PRESENTING AS ACUTE MYELONEUROPATHY. Med. res. chronicles [Internet]. 2018Oct.31 [cited 2024Apr.19];5(5):330-3. Available from: https://medrech.com/index.php/medrech/article/view/321
Section
Case Study
