一氧化二氮滥用与相关神经系统疾病。
Nitrous oxide abuse and associated neurological diseases.
机构信息
Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Center of Excellence in Neuroscience, Bangkok International Hospital, Bangkok, Thailand.
出版信息
BMC Neurol. 2024 Nov 26;24(1):461. doi: 10.1186/s12883-024-03966-9.
OBJECTIVES
Nitrous oxide has long been used as an anesthetic agent. The recreational use and abuse are rapidly increased in Western countries and lead to many neurological complications.
METHODS
Retrospectively review of seven patients.
RESULTS
Seven patients aged 19-32 years, mean 22.6 years. They inhaled nitrous oxide between 1 month to 1 year prior to the symptom onset. They all presented with acute or subacute ataxia or motor, and sensory dysfunction. The two had coexisting encephalopathy. Electrodiagnosis showed sensorimotor axonal polyneuropathy. All patients had borderline or low serum vitamin B12 level. Two had high serum homocysteine or methylmalonic acid levels. Cervical spine MRI in two patients showed posterior column lesion. At average 2 month-follow up, all patients had minimal improvement. While at more than 6 month-follow up, most patients had moderate to complete recovery.
CONCLUSION
Seven patients with nitrous oxide induced neurological disease are reported. All patients present with acute myelopathy and sensorimotor polyneuropathy. Short term outcome is generally not favorable while long term outcome shows remarkable improvement.
目的
一氧化二氮作为一种麻醉剂已应用多年。在西方国家，其消遣性使用和滥用迅速增加，导致许多神经并发症。
方法
回顾性分析了 7 名患者。
结果
7 名患者年龄 19-32 岁，平均 22.6 岁。他们在症状出现前 1 个月至 1 年内吸入了一氧化二氮。他们均表现为急性或亚急性共济失调或运动、感觉功能障碍。其中 2 人伴有脑病。电诊断显示感觉运动性轴索性多发性神经病。所有患者的血清维生素 B12 水平均处于边缘或低值。2 名患者的血清同型半胱氨酸或甲基丙二酸水平升高。2 名患者的颈椎 MRI 显示后柱病变。平均随访 2 个月时，所有患者均有轻微改善。随访 6 个月以上时，大多数患者的病情从中度至完全恢复。
结论
报告了 7 例一氧化二氮引起的神经系统疾病患者。所有患者均表现为急性脊髓病和感觉运动性多发性神经病。短期预后一般不佳，而长期预后显示显著改善。
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