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Reversible nitrous oxide-induced myeloneuropathy with pernicious anemia: case report and literature review
Authors:Singer Mike A  Lazaridis Christos  Nations Sharon P  Wolfe Gil I
Institution:Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-8897, USA. mike.singer@utsouthwestern.edu
Abstract: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.
Keywords:cobalamin  nitrous oxide  pernicious anemia  vitamin B12 deficiency
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