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Case Reports in Neurological Medicine
Volume 2015, Article ID 827168, 3 pages
http://dx.doi.org/10.1155/2015/827168
Case Report

Funicular Myelosis in a Butcher: It Was the Cream Cans

1Department of Neurology, University Hospital Zürich, Frauenklinikstrasse 26, 8091 Zürich, Switzerland
2Medizinisch Radiologisches Institut (MRI Bethanien), Toblerstrasse 51, Bahnhofplatz, Stadelhofen, 8044 Zürich, Switzerland
3Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Lenggstrasse 31, 8032 Zürich, Switzerland
4Neurorehabilitation, RehaClinic, Quellenstrasse 34, 5330 Bad Zurzach, Switzerland

Received 14 December 2014; Accepted 9 January 2015

Academic Editor: José Luis González-Gutiérrez

Copyright © 2015 Fabian Wolpert et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Funicular myelosis is a known consequence of exposure to nitrous oxide. Nevertheless, there are only a few clinical trials assessing its long-term effects and there is no literature about the role of nutritional vitamin B12 supplementation in the context of nitrous oxide abuse. Case Descriptions. We diagnosed funicular myelosis in a young butcher, who consumed high amounts of meat regularly. Since the diagnostic process did not reveal any metabolic causes, reinterrogation of the patient uncovered recreational abuse of nitrous oxide out of whipped cream can gas cartridges. After stopping abuse and supplementation of vitamin B12, the patient recovered almost completely. Conclusions. In our case, even high nutritional vitamin B12 uptake could not compensate the noxious effects of nitrous oxide. Since there are emerging reports of increasing misuse, this should be considered in the diagnostic and therapeutic care of patients with nitrous oxide abuse. Furthermore, our case emphasizes that patients with vitamin B12 deficiency should be assessed for nitrous oxide abuse.