Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8939857 | British Journal of Anaesthesia | 2006 | 4 Pages |
Abstract
We present a case of a patient who received nitrous oxide on two occasions within a period of 8 weeks and who subsequently developed a diffuse myelopathy, characterized by upper extremity paresis, lower extremity paraplegia and neurogenic bladder. Laboratory testing revealed hyperhomocysteinaemia and low levels of vitamin B12. Because of this uncommon clinical presentation, we analysed the patient's DNA, and found a polymorphism in the MTHFR gene that is associated with the thermolabile isoform of the 5,10-methylenetetrahydrofolate reductase enzyme, which explained the myelopathy experienced by the patient after being exposed to nitrous oxide. Soon after initiating supplementary therapy with folic acid and vitamin B12, the neurological symptoms subsided.
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Authors
H.J. Lacassie, C Nazar, B Yonish, P Sandoval, H.A. Muir, P Mellado,