[Nitric-oxide triggered neurological disorders in subjects with vitamin B12 deficiency].
BACKGROUND
Nitrous oxide is frequently used for anesthesia. It may cause spinal cord toxicity.


METHODS
We report two patients who presented gait disorders after nitrous oxide anesthesia. Physical examination revealed arms and legs pyramidal syndrome and abnormal proprioception, consistent with subacute combined degeneration of the spinal cord. Serum vitamin B12 level was extremely low. The patients improved with parenteral treatment with hydroxycobalamin.


CONCLUSIONS
The inactivation of methionine synthase and L methylmalonylcoA mutase by nitrous oxide has been previously demonstrated. Anesthesia-related exposure to nitrous oxide may induce neurologic disorders even in patients with no preliminary vitamin B12 deficiency.
Cohen Aubart
F
F
Assistance Publique-Hôpitaux de Paris, Fédération des maladies du Système Nerveux, et Université Pierre et Marie Curie, Groupe Hospitalier Pitié Salpêtrière 47-83 boulevard de l'hôpital 75013 Paris, France.
Sedel
F
F
Vicart
S
S
Lyon-Caen
O
O
Fontaine
B
B
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009410:Nerve Degeneration / Q000150:complications; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000150:complications; D009569:Nitric Oxide / Q000494:pharmacology*; D014806:Vitamin B 12 Deficiency / Q000150:complications*
D009569:Nitric Oxide