School of Medicine Publications and Presentations
Document Type
Article
Publication Date
2-2023
Abstract
Nitrous oxide, also known as “laughing gas,” is a naturally occurring gas that is colorless, odorless, nonflammable, and nontoxic. It has been used as an inhalant anesthetic in the medical field for more than 150 years for dental and surgical procedures. Due to its wide availability and ability to cause euphoria, its recreational use is on the rise. We present a case of subacute combined degeneration (SCD) due to nitrous oxide-induced vitamin B12 deficiency. The patient presented with bilateral lower extremity paresthesia, weakness, and ataxic gait. The patient was found to have vitamin B12 deficiency. An MRI of the cervical spine revealed an abnormal T2 signal within the cervical spinal cord extending from the level of C2-C6 affecting only the posterior column. On the fifth day of hospitalization, the patient reported that he had been inhaling nitric oxide from whipped cream cans for recreational use. According to his clinical presentation and laboratory and imaging findings, we concluded that the patient had SCD. The patient slowly improved after receiving vitamin B12 supplementation therapy. Patients presenting with paresthesia, weakness, and laboratory studies indicating vitamin B12 deficiency should be questioned about nitrous oxide recreational use since the incidence is increasing.
Recommended Citation
Nadal Bosch, J., Malcolm, J., Moya, M., Menowsky, M., & Cruz, R. A. (2023). A Case Report of Subacute Combined Degeneration Due to Nitrous Oxide-Induced Vitamin B12 Deficiency. Cureus, 15(2), e34514. https://doi.org/10.7759/cureus.34514
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Cureus
DOI
10.7759/cureus.34514
Academic Level
faculty
Mentor/PI Department
Internal Medicine
Comments
© Copyright 2023 Nadal Bosch et al.