Cohen Aubart F, Sedel F, Vicart S, Lyon-Caen O, Fontaine B. Troubles neurologiques par carence en vitamine B12 déclenchés par le protoxyde d’azote.
Rev Neurol (Paris) 2007;
163:362-4. [PMID:
17404524 DOI:
10.1016/s0035-3787(07)90409-9]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION
Nitrous oxide is frequently used for anesthesia. It may cause spinal cord toxicity.
CASE REPORTS
We report two patients who presented gait disorders after nitrous oxide anesthesia. Physical examination revealed arms and legs pyramidal syndrome and abnormal proprioception, consistent with subacute combined degeneration of the spinal cord. Serum vitamin B12 level was extremely low. The patients improved with parenteral treatment with hydroxycobalamin.
CONCLUSIONS
The inactivation of methionine synthase and L methylmalonylcoA mutase by nitrous oxide has been previously demonstrated. Anesthesia-related exposure to nitrous oxide may induce neurologic disorders even in patients with no preliminary vitamin B12 deficiency.
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