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February 1942

MOMENTARY DEATH AND CHOREOATHETOSIS FOLLOWING NITROUS OXIDE ANESTHESIA WITH RECOVERY

Author Affiliations

Psychiatrist-in-Charge, Kings County Hospital With the Technical Assistance of Solomon Machover, M.A. Senior Psychologist BROOKLYN

Arch NeurPsych. 1942;47(2):245-253. doi:10.1001/archneurpsyc.1942.02290020061005
Abstract

Many reports1 have recently appeared describing damage to the brain following the use of nitrous oxide anesthesia, the pathologic changes being found predominantly in the cerebral cortex and the basal ganglia. Most of the patients die during the anesthesia or a short time thereafter. Sudden death, coma, convulsions, decerebrate phenomena, delirium, paralysis, hyperthermia, visual defects, aphasias and amnesia and mental and psychic changes have been reported in various combinations, with partial or complete recovery. The appearance of a clearcut clinical picture of extrapyramidal disease characterized mainly by choreoathetosis is rare.

In 1887 Savage2 cited a case of delirium in which "irregular movements of all kinds were being made." The patient finally became demented and was placed in an institution, where she remained "silly and fat." In only 1 of Caine's3 4 cases, reported in 1923, did choreoathetoid movements develop as part of a residual picture, accompanied by

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