一名儿科患者的一氧化二氮脊髓病

Nitrous oxide myelopathy in a pediatric patient.

作者信息

Hu Mei-Hua, Huang Go-Shine, Wu Chang-Teng, Hung Po-Cheng

机构信息

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.

出版信息

Pediatr Emerg Care. 2014 Apr;30(4):266-7. doi: 10.1097/PEC.0000000000000110.

DOI:10.1097/PEC.0000000000000110

PMID:24694883

Abstract

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.

摘要

目的

儿童中氧化亚氮脊髓病较为罕见。我们报告一名16岁女孩，她因四肢进行性上升性麻木1周及感觉性共济失调4天就诊于儿科急诊科。该患者在过去3个月频繁吸入氧化亚氮用于消遣。她的血清维生素B12、同型半胱氨酸和叶酸水平均在正常范围内。脊髓T2加权图像系列的磁共振成像显示，C1至C6节段的颈髓中央和背侧部分呈高信号，T7和T8节段的胸髓部分可疑高信号。