A 35-year-old female dentist laid on her chair to test an N2O machine, and after only a few minutes of inhaling the N2O, she developed acute pyramidal syndrome. The patient started walking again eight months later, but still suffers from lower limb motor deficit, in spite of intensive rehabilitation. Genetic tests later showed that the patient had Type 3 homocystinuria.
This is the first case report of acute neurological toxicity after brief administration of N2O. We suggest starting vitamin B12 and folic acid supplements promptly in patients who experience neurological symptoms after receiving N2O.
Key words: case report, neurological toxicity, nitrous oxide, adverse reaction, homocystinuria, dental care