Abstract：
Purpose The abuse of nitrous oxide (N2O) can induce Vitamin B12 deficiency that subsequently leads to central nervous demyelination, myelopathy and peripheral neuropathy. Although myelopathy has been reported in the past, the specific locations and prognosis of the disease are still unclear.
METHODS: We report the case of a 22-year-old male who presented with quadriplegia that began after a 3-month history of inhalation of N2O. We summarized the clinical data of this entity and performed a comprehensive literature review of various presentations and MRI features of myelopathy secondary to N2O abuse.
RESULTS: In combination with previous reports of 14 cases, we found that the onset of the disease was usually subacute, and the majority of patients (92.85%) were young men. There was no definite relationship between myelopathy and the amount or duration of N2O inhalation. The most common clinical manifestation was sensory ataxia, and the cervical spinal cord was the most frequently impaired area of the whole spinal cord. The spinal cord lesions had a high signal intensity on T2-weighted MRI and usually involved more than three spinal segments and impaired the posterior column more significantly. Most patients recovered well after vitamin B12 supplementation.
CONCLUSIONS: Myelopathy secondary to N2O abuse is generally seen in young men. The clinical diagnosis mainly depends on a history of N2O inhalation and the characteristic imaging changes in the posterior cervical spinal cord. Early diagnosis and intervention are important for a satisfactory prognosis.
METHODS: We report the case of a 22-year-old male who presented with quadriplegia that began after a 3-month history of inhalation of N2O. We summarized the clinical data of this entity and performed a comprehensive literature review of various presentations and MRI features of myelopathy secondary to N2O abuse.
RESULTS: In combination with previous reports of 14 cases, we found that the onset of the disease was usually subacute, and the majority of patients (92.85%) were young men. There was no definite relationship between myelopathy and the amount or duration of N2O inhalation. The most common clinical manifestation was sensory ataxia, and the cervical spinal cord was the most frequently impaired area of the whole spinal cord. The spinal cord lesions had a high signal intensity on T2-weighted MRI and usually involved more than three spinal segments and impaired the posterior column more significantly. Most patients recovered well after vitamin B12 supplementation.
CONCLUSIONS: Myelopathy secondary to N2O abuse is generally seen in young men. The clinical diagnosis mainly depends on a history of N2O inhalation and the characteristic imaging changes in the posterior cervical spinal cord. Early diagnosis and intervention are important for a satisfactory prognosis.
摘要：
目的一氧化二氮（N2O）的滥用可引起维生素B12缺乏，随后导致中枢神经脱髓鞘，脊髓病和周围神经病变。虽然脊髓病在过去已有报道,该病的具体部位和预后尚不清楚.
方法：我们报告了一例22岁男性，在吸入N2O3个月后出现四肢瘫痪。我们总结了该实体的临床数据，并对N2O滥用继发的脊髓病的各种表现和MRI特征进行了全面的文献综述。
结果：结合以往14例报告，我们发现这种疾病的发作通常是亚急性的，大多数患者(92.85%)是年轻男性。脊髓病与吸入N2O的量或持续时间之间没有明确的关系。最常见的临床表现是感觉性共济失调，颈脊髓是整个脊髓中最常见的受损区域。脊髓病变在T2加权MRI上具有高信号强度，通常涉及三个以上的脊柱节段，并且后柱受损更明显。大多数患者在补充维生素B12后恢复良好。
结论：N2O滥用继发的脊髓病通常见于年轻男性。临床诊断主要取决于N2O吸入史和颈后脊髓的特征性影像学改变。早期诊断和干预对于获得满意的预后至关重要。
方法：我们报告了一例22岁男性，在吸入N2O3个月后出现四肢瘫痪。我们总结了该实体的临床数据，并对N2O滥用继发的脊髓病的各种表现和MRI特征进行了全面的文献综述。
结果：结合以往14例报告，我们发现这种疾病的发作通常是亚急性的，大多数患者(92.85%)是年轻男性。脊髓病与吸入N2O的量或持续时间之间没有明确的关系。最常见的临床表现是感觉性共济失调，颈脊髓是整个脊髓中最常见的受损区域。脊髓病变在T2加权MRI上具有高信号强度，通常涉及三个以上的脊柱节段，并且后柱受损更明显。大多数患者在补充维生素B12后恢复良好。
结论：N2O滥用继发的脊髓病通常见于年轻男性。临床诊断主要取决于N2O吸入史和颈后脊髓的特征性影像学改变。早期诊断和干预对于获得满意的预后至关重要。
