Nitrous oxide myelopathy in a pediatric patient.
OBJECTIVE
Nitrous oxide myelopathy is rare in children. We report a 16-year-old girl who presented at the pediatric emergency department with progressive ascending numbness in 4 limbs for 1 week and sensory ataxia for 4 days. The patient had frequently inhaled nitrous oxide for recreation over the preceding 3 months. Her serum vitamin B12, homocysteine, and folate levels were within normal ranges. Magnetic resonance imaging of the spinal cord T2-weighted images series showed hyperintensities in the central and dorsal cervical spinal cord section over C1 to C6 and suspicious of hyperintensities in the thoracic spinal section over T7 and T8.


CONCLUSIONS
Myelopathy due to nitrous oxide should be considered in a differential diagnosis when adolescents develop neurologic symptoms after nitrous oxide inhalation abuse.
From the *Department of General Pediatric, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, †Department of Pediatric, Chang Gung Memorial Hospital at Keelung, and ‡Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan; §Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Nei-Hu, Taipei; and ∥Department of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Mei-Hua
MH
Hu
Go-Shine
GS
Huang
Chang-Teng
CT
Wu
Po-Cheng
PC
Hung
D000280:Administration, Inhalation; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009609:Nitrous Oxide / Q000009:adverse effects*; D013118:Spinal Cord Diseases / Q000139:chemically induced* / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology*
D018712:Analgesics, Non-Narcotic; D018685:Anesthetics, Inhalation; D009609:Nitrous Oxide