Emergency Cases Northwest Group

073 No Laughing Matter

Situation

Adolescent had neurological symptoms from nitrous oxide abuse.

Background

A teenager presented with numbness to both feet. She had a history of recreational use of of nitrous oxide [known as laughing gas or entonox]. B12 levels were normal, as was MRI spine. Specialist neurological review suggested functional B12 deficiency: treated with IM B12 injections.

Assessment

Even though the B12 levels were normal it was still possible that the nitrous oxide was responsible for her neurological symptoms.

Recommendation

Be aware that in the patient with neurological symptoms with normal B12 levels, IM B12 injections may still be indicated, as per Toxbase.



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Emergency Cases Northwest Group