• BMJ case reports · Feb 2019

    Case Reports

    Nitrous oxide myelopathy with functional vitamin B 12 deficiency.

    • John Williamson, Saif Huda, and Dinesh Damodaran.
    • Department of Neurology, The Walton Centre Foundation NHS Trust, Liverpool, UK.
    • BMJ Case Rep. 2019 Feb 13; 12 (2).

    AbstractRecreational use of nitrous oxide as a 'legal high' is increasing in the UK. Physicians should be 'street wise' to this increasing prevalence and aware of the potential neurological complications which may result from misuse. We describe a 17-year-old male patient who presented to neurology with a severe myelopathy following prolonged recreational use of nitrous oxide. MRI demonstrated characteristic changes affecting the dorsal columns and blood tests demonstrated a 'functional' B12 deficiency. Clinical and radiological improvement was noted following initiation of vitamin B12 replacement.© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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