Journal
BRITISH JOURNAL OF ANAESTHESIA
Volume 96, Issue 2, Pages 222-225Publisher
OXFORD UNIV PRESS
DOI: 10.1093/bja/aei300
Keywords
anaesthesia, inhalation; anaesthetics gases, nitrous oxide; complications, myelopathy; enzymes, 5,10-methylenetetrahydrofolate reductase; gene, MTHFR; vitamins, folic acid
Categories
Ask authors/readers for more resources
We present a case of a patient who received nitrous oxide on two occasions within a period of 8 weeks and who subsequently developed a diffuse myelopathy, characterized by upper extremity paresis, lower extremity paraplegia and neurogenic bladder. Laboratory testing revealed hyper-homocysteinaemia and low levels of vitamin B-12. Because of this uncommon clinical presentation, we analysed the patient's DNA, and found a polymorphism in the MTHFR gene that is associated with the thermolabile isoform of the 5,10-methylenetetrahydrofolate reductase enzyme, which explained the myelopathy experienced by the patient after being exposed to nitrous oxide. Soon after initiating supplementary therapy with folic acid and vitamin B12, the neurological symptoms subsided.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available