从兴奋到低落：一氧化二氮娱乐性使用导致亚急性联合变性脊髓的警示故事
'From highs to lows: a cautionary tale of nitrous oxide recreational use leading to sub-acute combined degeneration of the cord'.
作者信息
Osman Ayman, Yousif Dalia, Hickman Simon, Branagh William
机构信息
Acute Medicine Department, Bolton NHS Foundation Trust, Minerva Road, Bolton BL4 0JR, United Kingdom.
Acute Medicine Department, Sandwell and West Birmingham NHS Trust, West Bromwich, Birmingham B71 4HJ, United Kingdom.
出版信息
Oxf Med Case Reports. 2024 Jul 13;2024(7):omae068. doi: 10.1093/omcr/omae068. eCollection 2024 Jul.
BACKGROUND
Several causes lead to subacute combined degeneration (SACD) of the spinal cord, with nitrous oxide (N2O) inhalation rapidly emerging as the leading cause of functional Vitamin B12 deficiency [1].
CASE PRESENTATION
A 28-year-old man presented with numbness in the extremities and an unstable gait despite having a normal serum Vitamin B12 level. He also disclosed the recreational abuse of N2O. Magnetic Resonance Imaging (MRI) of the cervical spine revealed abnormal signals consistent with SACD. The patient's condition gradually improved after treatment with high dose Vitamin B12. Given the increasing number of N2O-induced SACD cases, the potential for drug abuse requires vigilance from clinicians.
CONCLUSION
Healthcare providers are urged to inquire about a patient's history of N2O inhalation to prevent the missed diagnosis of SACD.
背景
脊髓亚急性联合变性（SACD）有多种病因，随着氧化亚氮（N₂O）吸入迅速成为功能性维生素B₁₂缺乏的主要原因[1]。
病例介绍
一名28岁男性，尽管血清维生素B₁₂水平正常，但出现肢体麻木和步态不稳。他还透露有吸食N₂O消遣的情况。颈椎磁共振成像（MRI）显示与SACD一致的异常信号。高剂量维生素B₁₂治疗后患者病情逐渐改善。鉴于N₂O诱导的SACD病例数量不断增加，药物滥用的可能性需要临床医生保持警惕。
结论
敦促医疗服务提供者询问患者吸入N₂O的病史，以防止漏诊SACD。
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