Rehabilitation essential in the recovery of multifactorial subacute combined degeneration

Chin, Joseph L.; Forzani, Brian R.; Chowdhury, Nayeema; Lombardo, Sergio R.; Rizzo, John Ross; Ragucci, Mark V.

doi:10.1016/j.rehab.2014.12.005

Cited by 12 publications

(6 citation statements)

References 7 publications

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“…For example, one case had prominent neurologic and psychiatric symptoms together and was placed into the Psychiatric category. 51…”

Section: Search Resultsmentioning

confidence: 99%

“…Patients had neurological complaints at presentation in 72 out of the 91 cases, or 73 if including a case classified under Primary Psychiatric Presentations (see Table 1). 51 Common diagnoses included myeloneuropathy (N ¼ 31), subacute combined degeneration (N ¼ 17), peripheral neuropathy or polyneuropathy (N ¼ 15), and myelopathy (N ¼ 14). The most common complaints were "numbness" (32 cases), "paresthesias" (31 cases), and "weakness" (27 cases).…”

Section: Nitrous Oxide Abuse and Neurologic Sequelaementioning

confidence: 99%

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Neurologic, psychiatric, and other medical manifestations of nitrous oxide abuse: A systematic review of the case literature

et al. 2016

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“…For example, one case had prominent neurologic and psychiatric symptoms together and was placed into the Psychiatric category. 51…”

Section: Search Resultsmentioning

confidence: 99%

Section: Nitrous Oxide Abuse and Neurologic Sequelaementioning

confidence: 99%

Neurologic, psychiatric, and other medical manifestations of nitrous oxide abuse: A systematic review of the case literature

et al. 2016

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“…It also promotes the survival of neurons and supports myelin regeneration ( 9 ). Early rehabilitation is also essential for the recovery of nerve function and can vastly reduce the extent of nerve damage ( 10 ). When there is abnormal mental behavior, we should also pay attention to effective psychological counseling, give patients active psychological support treatment, encourage patients to stay away from N 2 O, and develop healthy work and living habits.…”

Section: Discussionmentioning

confidence: 99%

Case report: Subacute combined degeneration of the spinal cord due to nitrous oxide abuse

Huang

et al. 2023

Front. Neurol.

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BackgroundNitrous oxide (N2O) is an increasingly popular recreational drug. N2O irreversibly disturbs the metabolism of vitamin B12, resulting in a functional deficiency. Vitamin B12 is vital for myelin synthesis and its deficiency primarily produces neurological complications. Inhaling N2O is more common and neurological complications are more evident than before.Case presentationWe report a young man who developed progressive limb numbness and unsteady walking after N2O abuse. The dominant diagnosis was subacute combined degeneration of the spinal cord (SCD). The patient was admitted to the hospital and given adenosylcobalamin treatment, but his symptoms progressed significantly from before and he developed acute cognitive impairment. After methylprednisolone combined with vitamin B12 treatment, symptoms significantly improved.ConclusionClinicians need to understand the presentation and treatment of SCD caused by N2O abuse. When symptoms progress despite conventional vitamin B12 therapy, the combination of methylprednisolone and vitamin B12 may be considered.

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“…Two patients [23,28] presented with a history of vitamin B12 deficiency. These patients were not excluded, as their symptoms presumably emerged after a further decrease in vitamin B12 concentration through nitrous oxide abuse.…”

Section: Discussionmentioning

confidence: 99%

Does vitamin B12 deficiency explain psychiatric symptoms in recreational nitrous oxide users? A narrative review

Paulus

Wijnhoven

Maessen

et al. 2021

Clinical Toxicology

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Background Recreational use of nitrous oxide (N 2 O) is associated with many side effects, of which neurological complications are most common. Nitrous oxide abuse is also associated with psychiatric symptoms, but these have received less attention so far. Vitamin B12 deficiency may play a role in the development of these psychiatric symptoms. Aims To explore the relationship among the occurrence of recreational nitrous oxide-induced psychiatric symptoms, accompanying neurological symptoms, vitamin B12 status and choice of treatment. Methods A retrospective search for case reports was conducted across multiple databases (Pubmed, Embase, Web of Science, PsycINFO and CINAHL). Keywords included variants of "nitrous oxide", "case report" and "abuse". No restrictions to language or publication date were applied. Results The search retrieved 372 articles. A total of 25 case reports were included, representing 31 patients with psychiatric complications following nitrous oxide abuse. The most often reported symptoms were: hallucinations (n ¼ 16), delusions (n ¼ 11), and paranoia (n ¼ 11). When neurological symptoms were present, patients were treated more frequently with vitamin B12 supplementation. Conclusions This review highlights the need to recognize that psychiatric symptoms may appear in association with nitrous oxide use. Approximately half of the cases that presented with nitrous oxideinduced psychiatric complaints did not show neurological symptoms, and their vitamin B12 concentration was often within the hospital's reference range. Psychiatrists and emergency physicians should be aware of isolated psychiatric symptoms caused by recreational nitrous oxide abuse. We suggest asking all patients with new psychiatric symptoms about nitrous oxide use and protocolizing the management of nitrous oxide-induced psychiatric symptoms.

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Rehabilitation essential in the recovery of multifactorial subacute combined degeneration

Cited by 12 publications

References 7 publications

Neurologic, psychiatric, and other medical manifestations of nitrous oxide abuse: A systematic review of the case literature

Neurologic, psychiatric, and other medical manifestations of nitrous oxide abuse: A systematic review of the case literature

Case report: Subacute combined degeneration of the spinal cord due to nitrous oxide abuse

Does vitamin B12 deficiency explain psychiatric symptoms in recreational nitrous oxide users? A narrative review

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