'Anesthesia paresthetica': nitrous oxide-induced cobalamin deficiency.
A man with a subclinical cobalamin deficiency developed syncope, vertigo, paresthesias, and ataxia after two exposures to nitrous oxide anesthesia. Patients with unrecognized cobalamin deficiency may be particularly susceptible to brief exposures to nitrous oxide, which inactivates the cobalamin-dependent enzyme methionine synthase and may cause a myeloneuropathy. Clinicians should consider this entity when confronted with patients with neuropathic symptoms after surgical or dental procedures.
Kinsella
L J
LJ
Neuromuscular Center, Mt. Sinai Medical Center, Cleveland, OH 44106, USA.
Green
R
R
D000368:Aged; D000777:Anesthetics / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009609:Nitrous Oxide / Q000009:adverse effects*; D010292:Paresthesia / Q000139:chemically induced*; D014805:Vitamin B 12 / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology
D000777:Anesthetics; D009609:Nitrous Oxide; D014805:Vitamin B 12