Nitric Oxide–Induced Motor Neuron Disease in a Patient with Alcoholism

Abstract

To the Editor: Nitric oxide is a gas neurotransmitter involved in multiple physiologic and pathologic processes.1 We report a case in which the use of nitric oxide for the treatment of pulmonary hypertension after lung transplantation may have caused extensive lower motor neuron disorder. Nitric oxide activates guanylate cyclase, which is a transduction mechanism for the glutamatergic N-methyl-d-aspartate (NMDA) receptor. Glutamate and other excitatory amino acids can damage neurons if they persistently or excessively stimulate their receptors. They have been implicated in degenerative motor neuron diseases such as amyotrophic lateral sclerosis and Guam motor neuron. © 1995, Massachusetts Medical Society. All rights reserved.