Subacute combined degeneration of the spinal cord secondary to nitrous oxide-induced B12 deficiency

Abstract

A previously healthy adolescent male was admitted with paraesthesia of his arms and legs. He admitted to daily recreational nitrous oxide use for the previous 3–4 months. He was found to have severe vitamin B12 deficiency, while magnetic resonance imaging of his spine showed T2 hyperintensity within the dorsal columns. This was suggestive of subacute combined degeneration of the spinal cord. He was treated with intramuscular injections of hydroxocobalamin and showed moderate improvement 1 month post-discharge.