Reversible nitrous oxide-induced myeloneuropathy with pernicious anemia: Case report and literature review

A previously healthy 27-year-old woman developed a subacute myeloneuropathy after receiving nitrous oxide anesthesia for dental procedures, Neurologic evaluation revealed that she was vitamin B-12 deficient due to underlying pernicious anemia. Discontinuation of nitrous oxide and supplementation with vitamin B-12 resulted in dramatic clinical improvement, with near-complete normalization of her neurologic examination. This case and published reports reviewed here emphasize that favorable outcomes are possible following prompt recognition and treatment of vitamin B-12 deficiency.