{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:51:32Z","timestamp":1785588692314,"version":"3.56.0"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T00:00:00Z","timestamp":1424736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Introduction<\/jats:italic>: Nitrous oxide (N<jats:sub>2<\/jats:sub>O) toxicity can cause a sensory predominant myeloneuropathy identical to subacute combined degeneration caused by vitamin B12 deficiency. We describe a patient with a typical vitamin B12 deficiency syndrome after N<jats:sub>2<\/jats:sub>O abuse who recovered and then developed a severe lower motor neuron syndrome following vitamin B12 correction. This suggests N<jats:sub>2<\/jats:sub>O toxicity independent of functional vitamin B12 deficiency. <jats:italic>Methods<\/jats:italic>: Electrophysiological, serological, and clinical evaluations were undertaken in the evaluation of this patient. <jats:italic>Results<\/jats:italic>: A 22\u2010year\u2010old man abused N<jats:sub>2<\/jats:sub>O and presented with a dorsal column syndrome with low vitamin B12 and high homocysteine serum levels. He recovered with treatment but presented later with profound motor axonal degeneration and normal vitamin B12, homocysteine, and methlymalonic acid levels. <jats:italic>Conclusions<\/jats:italic>: This case illustrates that N<jats:sub>2<\/jats:sub>O\u2010associated severe motor neuropathy or neuronopathy can develop separately from typical vitamin B12 deficiency dorsal column myelopathy. This syndrome can present when functional measures of vitamin B12 deficiency have normalized. <jats:italic>Muscle Nerve<\/jats:italic> 51: 614\u2013616, 2015<\/jats:p>","DOI":"10.1002\/mus.24482","type":"journal-article","created":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T08:44:08Z","timestamp":1412844248000},"page":"614-616","source":"Crossref","is-referenced-by-count":49,"title":["Severe motor neuropathy or neuronopathy due to nitrous oxide toxicity after correction of vitamin B12 deficiency"],"prefix":"10.1002","volume":"51","author":[{"given":"Nicholas","family":"Morris","sequence":"first","affiliation":[{"name":"Partners Neurology Residency Brigham and Women's Hospital, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Lynch","sequence":"additional","affiliation":[{"name":"Partners Neurology Neuromuscular Fellowship, Brigham and Women's Hospital, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Neurology Harvard Medical School Division of Neuromuscular Disease Brigham and Women's Hospital, Children's Hospital Informatics Program, 75 Francis Street, and Harvard\u2010Massachusetts Institute of Technology, Division of Health Sciences and Technology Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,24]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(78)92101-3"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2010.10.033"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI110155"},{"key":"e_1_2_5_5_1","first-page":"43","article-title":"Myeloneuropathy from nitrous oxide abuse: unusually high methylmalonic acid and homocysteine levels","volume":"102","author":"Waclawik AJ","year":"2003","journal-title":"WMJ"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.28.5.504"},{"key":"e_1_2_5_7_1","first-page":"894","article-title":"Myelopathy caused by nitrous oxide toxicity","volume":"19","author":"Pema PJ","year":"1998","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_2_5_8_1","first-page":"2013","article-title":"Subacute combined degeneration of the spinal cord following recreational nitrous oxide use","author":"Cheng HM","year":"2013","journal-title":"BMJ Case Rep"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-009-0013-2"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.8.1608"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.3.380"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20840"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00812159"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2005.00473.x"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.24482","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.24482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:28:44Z","timestamp":1695572924000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.24482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,24]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1002\/mus.24482"],"URL":"https:\/\/doi.org\/10.1002\/mus.24482","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,24]]}}}