title: Neurologic problems associated with chronic nitrous oxide abuse in a non-healthcare worker.
abstract: Chronic exposure to nitrous oxide (N2O) is known to be associated with hematologic and neurologic abnormalities. When this syndrome occurs, it is generally seen in health care workers, especially dentists and anesthesiologists, who have access to nitrous oxide. Here, however, we report a case of a 55-year-old non-healthcare worker who presented with multiple neurological abnormalities. His serum vitamin B12 level was low but his Shilling test was normal. His neurologic symptoms improved after cessation of inhaling nitrous oxide and starting vitamin B12 therapy. Physicians should consider nitrous oxide abuse in non-healthcare workers presenting with neurologic symptom of unclear cause.
authors.affiliation: Department of Medicine, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA. yokokentaro@hotmail.com
authors.forename: K
authors.initials: K
authors.lastname: Iwata
authors.forename: G B
authors.initials: GB
authors.lastname: O'Keefe
authors.forename: A
authors.initials: A
authors.lastname: Karanas
mesh_terms: D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D009609:Nitrous Oxide / Q000633:toxicity*; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D013577:Syndrome; D014805:Vitamin B 12 / Q000097:blood / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology
chemical_list: D009609:Nitrous Oxide; D014805:Vitamin B 12