vitamin-b-12 and Paralysis

We present a case of a patient who received nitrous oxide on two occasions within a period of 8 weeks and who subsequently developed a diffuse myelopathy, characterized by upper extremity paresis, lower extremity paraplegia and neurogenic bladder. Laboratory testing revealed hyperhomocysteinaemia and low levels of vitamin B(12). Because of this uncommon clinical presentation, we analysed the patient's DNA, and found a polymorphism in the MTHFR gene that is associated with the thermolabile isoform of the 5,10-methylenetetrahydrofolate reductase enzyme, which explained the myelopathy experienced by the patient after being exposed to nitrous oxide. Soon after initiating supplementary therapy with folic acid and vitamin B(12), the neurological symptoms subsided.

Topics: Anesthetics, Inhalation; Folic Acid; Genetic Predisposition to Disease; Humans; Hyperhomocysteinemia; Male; Methylenetetrahydrofolate Reductase (NADPH2); Middle Aged; Nitrous Oxide; Paralysis; Polymorphism, Genetic; Postoperative Complications; Spinal Cord Diseases; Vitamin B 12

Topics: Adult; Aminopyrine; Anesthetics, Local; Anti-Inflammatory Agents; Back Pain; Cauda Equina; Dexamethasone; Drug Combinations; Female; Humans; Injections; Lumbosacral Region; Male; Middle Aged; Pain; Paralysis; Pelvis; Phenylbutazone; Spinal Cord; Thiamine; Vitamin B 12

The effect of cobalamin inactivation by the anaesthetic gas nitrous oxide on the concentration of S-adenosylmethionine (Ado Met) in brain and liver of fruit bats (Rousettus aegyptiacus) was examined. Test animals exposed to N2O-oxygen (50:50, v/v) developed ataxia and paralysis leading to death after an average of 9.8 weeks (n6). Animals receiving pteroylmonoglutamic acid supplements in the diet became ataxic earlier (mean 8.8 weeks) while those receiving methionine supplements survived for significantly longer periods (12.5 weeks, P less than 0.01). Plasma cobalamin levels indicated severe depletion of cobalamin stores in N2O-exposed animals. The mean concentration of Ado Met in the brain of N2O-treated bats was nearly 50% higher than that of untreated controls. Ado Met levels in treated bats receiving pteroylmonoglutamic acid or methionine supplements were respectively 18 and 25% higher than in controls. In contrast, the concentration of Ado Met in the liver of all the N2O-treated groups was slightly lower than in controls. These results suggest that the N2O-induced neuropathy in the fruit bat is not related to a depletion of Ado Met in the nervous system.

Topics: Animals; Brain; Cerebellar Ataxia; Chiroptera; Diet; Folic Acid; Liver; Methionine; Nitrous Oxide; Paralysis; S-Adenosylmethionine; Vitamin B 12

Topics: Anti-Infective Agents, Local; Clioquinol; Female; Humans; Male; Optic Neuritis; Paralysis; Peripheral Nervous System Diseases; Time Factors; Vitamin B 12

Topics: Adult; Aged; Alcoholism; Humans; Male; Middle Aged; Neuralgia; Paralysis; Paresthesia; Polyneuropathies; Polyradiculopathy; Vitamin B 12

Topics: Anti-Bacterial Agents; Diagnosis, Differential; Facial Paralysis; Female; Herpes Zoster; Humans; Middle Aged; Nicotinic Acids; Otitis Media; Palate; Paralysis; Peripheral Nervous System Diseases; Physical Therapy Modalities; Prednisolone; Theophylline; Thiamine; Vitamin B 12

Topics: Animals; Brain; Demyelinating Diseases; Diet; Erythrocyte Count; Haplorhini; Hematocrit; Hemoglobins; Macaca; Monkey Diseases; Nerve Degeneration; Nervous System; Papio; Paralysis; Peripheral Nerves; Spinal Cord; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Animals; Demyelinating Diseases; Haplorhini; Nerve Degeneration; Paralysis; Vitamin B 12

Topics: Humans; Paralysis; Rabies; Vitamin B 12

Topics: Amyotrophic Lateral Sclerosis; Catatonia; Erectile Dysfunction; Fatigue; Hemiplegia; Humans; Male; Mental Disorders; Neuritis; Paralysis; Spinal Cord; Thiamine; Trigeminal Neuralgia; Vitamin B 12; Vitamin B Complex

Topics: Anemia, Pernicious; Central Nervous System Diseases; Diagnosis; Humans; Intrinsic Factor; Muscle Spasticity; Paralysis; Spinal Cord; Spinal Diseases; Vitamin B 12

Topics: Biomedical Research; Deafness; Drug Therapy; Hearing Disorders; Hearing Loss; Humans; Paralysis; Recurrent Laryngeal Nerve; Tinnitus; Vitamin B 12; Vocal Cord Paralysis

Topics: Diathermy; Diencephalon; Encephalitis; Humans; Influenza, Human; Paralysis; Thiamine; Vitamin B 12

Topics: Corrinoids; Hematinics; Humans; Paralysis; Poliomyelitis; Vitamin B 12