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July 1983

Myeloneuropathy and Macrocytosis Associated With Nitrous Oxide Abuse

Author Affiliations

From the Department of Neurology, University of Wisconsin Medical School, Madison.

Arch Neurol. 1983;40(7):416-418. doi:10.1001/archneur.1983.04050070046009

• After four months of excessive nitrous oxide (N2O) exposure, a dentist had myeloneuropathy with spastic paraparesis, Lhermitte's sign, sensory shading, loss of position and vibration sense, ataxia, and impotence. Macrocytosis, hypersegmented neutrophils, and a reduced vitamin B12 level were associated with normal findings on gastric analysis and Schilling test. Complete hematologic and neurologic recovery followed N2O avoidance and vitamin therapy for six months.