Svensson Staffan, Karbassi Allan, Johnsson Magnus
specialist i allmänmedicin och klinisk farmakologi, Närhälsan Hjällbo vårdcentral, Göteborg.
ST-läkare i allmänmedicin, Närhälsan Hjällbo vårdcentral, Göteborg.
Lakartidningen. 2022 Feb 8;119:21200.
A 19 year old male presented to his GP with bilateral numbness and stiffness of hands and lower limbs, as well as muscle weakness and poor balance. The patient admitted recreational use of nitrous oxide (laughing gas) some days earlier. He was hospitalised and underwent a series of plasmapheresis treatments due to an initial suspicion of inflammatory myelitis. Further investigation gave evidence of cervical myelopathy which was deemed secondary to heavy use of nitrous oxide. Substitution therapy with hydroxycobalamine was initiated and the patient gradually recovered, although he was later found to have hyperhomocysteinaemia. The adverse effects of recreational nitrous oxide use are discussed, as well as potential pitfalls in diagnosis.
一名19岁男性因双手和下肢双侧麻木、僵硬，以及肌肉无力和平衡能力差，前往其全科医生处就诊。患者承认几天前曾娱乐性使用一氧化二氮（笑气）。由于最初怀疑为炎性脊髓炎，他被收治入院并接受了一系列血浆置换治疗。进一步检查发现有颈髓病，被认为是大量使用一氧化二氮所致。开始使用羟钴胺素替代疗法，患者逐渐康复，不过后来发现他患有高同型半胱氨酸血症。本文讨论了娱乐性使用一氧化二氮的不良反应以及诊断中的潜在陷阱。
