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This article has been peer reviewed. It is the authors' final version prior to publication in Journal of neurosurgery. Spine.

Volume 16, Issue 5, May 2012, Pages 489-491.

The published version is available at DOI: 10.3171/2012.2.SPINE11532. Copyright © American Association of Neurological Surgeons


The authors describe a patient who presented with acute tetraparesis and a proposed acute traumatic spinal cord injury that was the result of nitrous oxide myelopathy. This 19-year-old man sustained a traumatic fall off a 6-ft high wall. His examination was consistent with a central cord syndrome with the addition of dorsal column impairment. Cervical MRI demonstrated an isolated dorsal column signal that was suggestive of a nontraumatic etiology. The patient's symptoms resolved entirely over the course of 48 hours. Nitrous oxide abuse is increasing in prevalence. Its toxic side effects can mask vitamin B12 and folate deficiency and central cord syndrome. The patient's history and radiographic presentation are key to establishing a diagnosis.

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