Waclawik Andrew J, Luzzio Christopher C, Juhasz-Pocsine Katalin, Hamilton Valerie
Department of Neurology, University of Wisconsin Medical School, Madison, Wis. 53792, USA.
WMJ. 2003;102(4):43-5.
A 23-year-old patient developed diffuse paresthesias and sensory loss. He had mildly reduced serum vitamin B12 (B12) concentration with unusually high levels of methylmalonic acid (MMA) and homocysteine and no evidence of B12 malabsorption. Following parenteral B12 administration, his neurological deficit promptly resolved and B12 and MMA levels normalized, but elevated levels of homocysteine persisted. One year later, he admitted to inhaling nitrous oxide (N2O). After halting N2O abuse his homocysteine level normalized. This case demonstrates the importance of serum homocysteine level measurements in cases of suspected N2O toxicity [corrected].
一名23岁患者出现弥漫性感觉异常和感觉丧失。他的血清维生素B12（B12）浓度轻度降低，甲基丙二酸（MMA）和同型半胱氨酸水平异常升高，且无B12吸收不良的证据。经肠胃外给予B12后，他的神经功能缺损迅速缓解，B12和MMA水平恢复正常，但同型半胱氨酸水平仍持续升高。一年后，他承认吸入了一氧化二氮（N2O）。停止滥用N2O后，他的同型半胱氨酸水平恢复正常。该病例证明了在疑似N2O中毒病例中检测血清同型半胱氨酸水平的重要性[已修正]。
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