Subacute Combined Degeneration with Motor Neuropathy Following Nitrous Oxide Abuse

ABSTRACT

The neurotoxicity of nitrous oxide (N2O) is known to be mainly occurred by interference with action of vitamin B12. A 38-year-old male presented with progressive gait instability after recreational inhalational use of N2O for 2 months. Although spine magnetic resonance image showed typical subacute combined degeneration, nerve conduction study showed motor neuropathy that is atypical findings of vitamin B12 deficiency. This case suggests N2O-induced neuropathy can develop separately from a vitamin B12 deficiency.