• Corpus ID: 11228634

When Nitrous Oxide is No Laughing Matter

@inproceedings{Baum2007WhenNO,
  title={When Nitrous Oxide is No Laughing Matter},
  author={Victor C Baum},
  year={2007}
}
First synthesized by Joseph Priestley in 1772, the psychotropic effects of nitrous oxide were first appreciated (in the first person) by Humphrey Davy. From the time that nitrous oxide was first used for analgesia by Horace Wells in December 1844 until 1956, nitrous oxide was considered to be completely benign. Although there were two isolated case reports, the first clear association of nitrous oxide and hematologic disease came in a report by Lassen, et al. in the Lancet in 1956.(1) They… 

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References

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Reversible nitrous oxide myelopathy and a polymorphism in the gene encoding 5,10-methylenetetrahydrofolate reductase.

A polymorphism in the MTHFR gene is found 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.

Polyneuropathy from inhalation of N2O cartridges through a whippedcream dispenser

A generalized toxic polyneuropathy was identified in a 23-year-old woman after excessive intentional inhalation of compressed N2O delivered from cartridges through a whipped-cream dispenser, characterized principally by axonal degeneration.

Severe combined degeneration of the spinal cord after nitrous oxide anaesthesia in a vegetarian.

The patient had initial presentation with what seemed to be a spastic paraparesis and later evaluation suggested the possibility of young onset Parkinson's disease as she had developed wearing off dose responses early after initiation of treatment with Sinemet.

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The neurologic deterioration and death of a child anesthetized twice, over a short period, with nitrous oxide before an inherited deficiency in 5,10-methylenetetrahydrofolate reductase (MTHFR), which is critical in similar metabolic pathways, was diagnosed.

Inactivation of Methionine Synthetase by Nitrous Oxide in Mice

Exposure to trace levels of nitrous oxide for eight to 22 days produced a small but significant reduction in liver and brain methionine synthetase activity, and activity returned to control levels two to four days following inactivation.

Vitamin B12 deficiency in adolescents and young adults with phenylketonuria

It is recommended that complete blood count, serum B12, RBC folate, methylmalonic acid and homocysteine be routinely measured in adolescents and young adults with phenylketonuria.