Reversible nitrous oxide-induced myeloneuropathy with pernicious anemia: Case report and literature review

Abstract

A previously healthy 27-year-old woman developed a sub-acute myeloneuropathy after receiving nitrous oxide anesthesia for dental procedures. Neurologic evaluation revealed that she was vitamin B12 deficient due to underlying pernicious anemia. Discontinuation of nitrous oxide and supplementation with vitamin B12 resulted in dramatic clinical improvement, with near-complete normalization of her neurologic examination. This case and published reports reviewed here emphasize that favorable outcomes are possible following prompt recognition and treatment of vitamin B 12 deficiency. © 2007 Wiley Periodicals, Inc.