Myeloneuropathy recovery. Konagaya M, Matsumoto A, Takase S, et al.

Myeloneuropathy recovery The future burden of nitrous oxide-related myeloneuropathy depends on how effectively the government implements the advice from the Advisory Council to reduce the supply and sale of nitrous oxide for non-legitimate use. At our centre, a dedicated ambulatory care pathway, endorsed nationally, was established to treat and monitor patients with N2O-myeloneuropathy in 2021 and refined through three audit cycles. Keywords: copper, nutritional neurologic symptoms, early copper treatment, copper deficiency, copper myeloneuropathy Introduction Nitrous oxide (N2O) is the second most common recreational drug used by 16- to 24-year-olds in the UK. Aug 24, 2021 · This study reviewed 20 patients presenting between 2016 and 2020 to tertiary hospitals in Australia with myeloneuropathy due to heavy nitrous oxide misuse. Neurological deficits can improve with abstinence and B12 supplementati … Jul 21, 2003 · The two patients with CNS demyelination described by our group [2] and another with myeloneuropathy by Hedera et al [3] had profound copper deficiency associated with hyperzincemia of unknown cause. Introduction Copper deficiency (CD) is a rare cause of cytopenia and a form of myeloneuropathy similar to subacute combined degeneration due to vitamin B12 deficiency. Myeloneuropathy resulting from copper deficiency is similar to vitamin B 12 deficiency in clinical presentation (subacute combined degeneration). Mean serum and active B12 were normal; in c Nitrous oxide abuse is an uncommon cause of subacute combined degeneration of the spinal cord. May 28, 2013 · Wilson’s disease (WD) treatment focuses on removing excess copper from the body and preventing reaccumulation, but there are reports of neuropathy and myeloneuropathy (MN) linked to copper deficiency (CD) induced by excessive depletion [1]. There are many drugs and chemical agents that cause myelopathy or myeloneuropathy. 2. Mar 1, 2024 · Case report: Among the 5 patients included, 2 had a myeloneuropathy, 2 had a sensorimotor neuropathy, and 1 had a normal spinal cord magnetic resonance imaging and electromyography despite neurological manifestations consistent with myeloneuropathy. Reversible nitrous oxide-induced myeloneuropathy with pernicious anemia: Case report and literature review. In 2010, a review of 55 published cases of myelopathy due to CD found that the deficiency was most frequently attributed to malabsorption due to gastrointestinal May 22, 2025 · Toxic and drug-induced myelopathies Some myelopathies can result from toxins, such as nitrous oxide or heroin. Both types of patients usually have a spastic ataxic gait and dorsal column deficits. Teodoro T, Neutel D, Lobo P, et al. Combined with evidence of predominant involvement in the cervical white matter tracts of the posterior cord, this may explain why the lower limbs are more affected. Jun 3, 2024 · Cases of nitrous oxide (N[2] O)-induced myeloneuropathy are increasing at UK hospitals. Neurologic findings of copper deficiency are often underrecognized and therefore not treated. Konagaya M, Matsumoto A, Takase S, et al. The known causes of acquired copper deficiency include prior gastric surgery Further evaluation with nerve conduction velocity and electromyographic testing was deferred. Methods We describe 119 patients with N2O-myeloneuropathy seen at NHS teaching hospitals in three of the UK’s largest cities: London, Birmingham and Copper deficiency myeloneuropathy resembling B12 deficiency: partial resolution of MR imaging findings with copper supplementation. . The commonly identified causes of acquired copper deficiency include a prior history of gastric surgery, excessive zinc ingestion, and malabsorption. Apr 28, 2023 · Introduction: Organophosphorus (OP) compounds, with their lipophilicity, are responsible for a spectrum comprising of acute cholinergic symptoms, intermediate syndrome, as well as delayed neurological sequelae in the form of OP-induced delayed neuropathy and subsequently, myeloneuropathy with predominantly thoracic cord affection, manifested on partial recovery of the neuropathy. Patients often present with an array of symptoms, which can lead to diagnostic challenges. On examination, there are myelopathic signs such as hyperreflexia, spasticity Nitrous oxide misuse can cause a severe but potentially reversible subacute myeloneuropathy. Nitrous oxide irreversibly inactivates vitamin B12 causing demyelination of the dorsa… Feb 20, 2020 · If recovery is not seen then; the dose may be increased to 4to 6 mg, which may contribute to achieve remission. From the literature review, 154 patients were The findings were in keeping with myeloneuropathy with possible subacute combined degeneration of the cord (SACD); the likeliest aetiology was functional vitamin B 12 deficiency caused by nitrous oxide use. It is usually due to compression of the spinal cord by osteophyte or extruded disc material. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. After vitamin B 12 supplementation, recovery was reported in 4 patients, and 1 was lost to follow-up. While the exact pathophysiology underlying central nervous system dysfunction in copper deficiency remains uncertain, interval recovery is possible with expedient parenteral and continued enteral supplementation. Background Use of nitrous oxide as a legal recreational agent is increasing with relative B12 deficiency a recognised complication. Neurological symptoms can occur in some people that use N2O recreationally, but most information comes from small case series. Apr 28, 2025 · It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. At our centre, a dedicated ambulatory care pathway, endorsed nationally, was established to treat and monitor patients with N[2] O-myeloneuropathy in 2021 and refined Mar 25, 2021 · Arq Neuropsiquiatr 2014; 72:255. Eleven cases of non-compressive myeloneuropathy were admitted to the Department of General Medicine of Burdwan Medical College and Hospital, Burdwan, West Bengal, India, between May 2018 and May 2022. Clinical analysis of longstanding subacute myelo-optico-neuropathy: sequelae of clioquinol at 32 years after its ban. Keywords: copper myeloneuropathy, ceruloplasmin transferrin, polyneuropathy, bariatric surgery, copper deficiency Introduction Copper plays a pivotal role in cellular transportation, mitochondrial oxidative metabolism, neurotransmitter biosynthesis, and maintaining the structure and function of the nervous and hematopoietic systems. It is most commonly localized in the cervical spine but it can also occur in the thoracic and lumbar spine. This is a case of a 27-year-old female exotic dancer who presented with clinical and laboratory manifestations of subacute combined degeneration of the May 10, 2023 · INTRODUCTION Copper deficiency-associated myelopathy has been well described in various animal species, in particular ruminants, in which it is called swayback or enzootic ataxia. Am J Neuroradiol. Jan 1, 2024 · Conclusion Meticulous historical analysis, careful clinical examination, and apposite utilization and interpretation of biochemical, electrophysiological, and neuroimaging findings are sine-qua-non for an accurate and consistent approach to evaluating a suspected case of myeloneuropathy, facilitating early treatment and recovery. 3. Based on the exam findings, clinical history, and presentation, a diagnosis of nitrous oxide-related myeloneuropathy was made, and treatment with high-dose vitamin B12 supplementation was instituted. Once the presence of myeloneuropathy is established, all these patients should be subjected to a battery of tests. The first case of CD-related myelopathy was reported in 2001 [1]. Clinical manifestations can be This review article identifies and describes the clinical manifestations of various metabolic, nutritional, and toxic conditions that result in symptoms of myelopathy and, in some cases, myeloneuropathy. Holloway KL, Alberico AM. [18] CONCLUSION Hypocupremic myeloneuropathy though rare, is a well-established entity. Myeloneuropathy signs and symptoms include difficulty in walking, weakness of lower limbs, ataxic gait, and sensory manifestations in glove and stocking distribution 1. Myeloneuropathy due to copper deficiency has been reported following treatment of Wilson disease with chelation and zinc [13 – 15]. [17] Copper doses of up to 9 mg per day have been reported to be used to prevent neurological worsening. The most common causes of acquired copper deficiency include malabsorption following gastric surgery and excessive zinc supplementation. These include clioquinol, organophosphate, and chemotherapeutic agents, such as cisplatin, intrathecal methotrexate, and anti-TNF medications. Recovery has been slow to date. 2006;27:2112–2114. 7 We theorise that the neuropathic component of N2O- myeloneuropathy first affects the longest peripheral nerves. It includes discussions of the clinical pictures that occur secondary to these causes. J Neurol 2013; 260:1917. Sep 15, 2009 · Copper deficiency myeloneuropathy may be present without hematological manifestations. Serum and active B12 can be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Muscle Nerve 2008;37:125-129. Copper deficiency myeloneuropathy has been well studied in animal species, but the relationship with neurologic disease in humans has been identified only recently. J Neurol Sci 2004; 218:85. J Neuro-surg 1990;72:732-736. Furthermore, early recognition has proved to be imperative in neurologic recovery and supplementation has proven to be successful in improving patient’s quality of life. 4. [1] There are many primary infectious, inflammatory, neurodegenerative, neoplastic Objectives To investigate the incidence and presentation of B12 related myeloneuropathy secondary to ingestion of recreational Nitrous Oxide. What is Myeloneuropathy Myeloneuropathy also called myelopathy is any disease affecting the spinal cord and peripheral nerves in the lower limbs 1. The Definition/Description Myelopathy is a term used to describe any neurologic deficit related to the spinal cord. Background Nitrous oxide (N2O) is the second most common recreational drug used by 16- to 24-year-olds in the UK. Familiarity with the clinical symptoms may lead to accurate diagnosis through laboratory and imaging Copper deficiency is a rare and potentially treatable cause of myeloneuropathy. Aug 31, 2013 · Further evaluation with nerve conduction velocity and electromyographic testing was deferred. This review article identifies and describes the clinical manifestations of various metabolic, nutritional, and toxic conditions that result in symptoms of myelopathy and, in some cases, myeloneuropathy. Acquired copper deficiency has been recognized to cause a myelopathy in humans relatively recently [1,2]; however, cases of myelopathy described among zinc-smelter workers in the 19 th century are now felt likely to The hematologic manifestations of copper deficiency are well known and include anemia and neutropenia. There has been a corresponding rise in cases of nitrous oxide-induced subacute combined degeneration of the cord (N2O-SACD), a pattern of myeloneuropathy usually associated with severe vitamin B12 deficiency. In the past few years, the neurological manifestations of acquired copper deficiency in humans has been recognized, the most common being a myelopathy presenting with a spastic gait and prominent sensory ataxia. Singer M, Lazaridis C, Nations S, et al. Postoperative myeloneuropathy: A preventable complication in patients with B12 deficiency. Method Retrospective study of patients referred to same day emergency care neurology service Imperial College NHS trust Aug 1, 2021 · Chronic nitrous oxide abuse is a known cause of myeloneuropathy. Copper binds with high affinity to metallothionein within the enterocytes leading to its excretion through the intestinal tract [12]. Familiarity with the clinical symptoms may lead to accurate diagnosis through laboratory and imaging Jun 3, 2024 · Introduction Cases of nitrous oxide (N 2O)-induced myeloneuropathy are increasing at UK hospitals. Summary: Deficiencies of vitamin B12, folate, copper, and vitamin E may result in characteristic clinical, electrodiagnostic, and imaging features. Recovery after copper-deficiency myeloneuropathy in Wilson's disease. The interplay between neurological and physiological factors defines myeloneuropathy. This section introduces the basic concepts and sets the stage for a deeper dive into myeloneuropathy. We describe 119 In conclusion, N 2 O abuse can cause various clinical and neurophysiological manifestations of myeloneuropathy along with psychiatric and medical sequelae. Blood levels of vitamin B12, folic acid, vitamins A, D, E, and K, along with levels of iron, methylmalonic acid, homocysteine, and calcium should be assessed. We analysed the outcomes of patients on this pathway to better understand factors associated with non Apr 25, 2023 · N2O- myeloneuropathy has both a myelopathic and a neuropathic element. Based on the exam findings, clinical history, and presentation, a diagnosis of nitrous oxide-related myeloneuropathy was made, and treatment with high-dose vitamin B 12 supplementation was instituted. This can cause serious and permanent disability in young people but, if recognised early, may be effectively treated. Feb 5, 2015 · These workers developed symptoms identical to those reported in the modern descriptive series of copper deficiency myeloneuropathy. b5rbq nha shql o2uw raq3v68yx 8ka donug 85bjw dg uk8biguzg