MYELONEUROPATHY FROM WHIPPED CREAM BULBS PRESENTING AS CONVERSION DISORDER

Objective: To highlight the complications of nitrous oxide abuse. Clin ical picture: A case is presented of a myeloneuropathy in a 21-year-ol d woman who had been abusing nitrous oxide, obtained from whipped crea m bulbs, who was referred to a psychiatric hospital with a diagnosis o f conversion disorder. Nitrous oxide toxicity has been reported in med ical and dental professions and a few cases of myeloneuropathy due to induced vitamin B12 deficiency have been reported. This would appear t o be the first reported case of myeloneuropathy resulting from nitrous oxide abuse from whipped cream propellants as a recreational drug in the community. Treatment: Three doses of intramuscular hydroxy cobalam in (1000 mu g) over the course of 1 week. Outcome: Her neurological sy mptoms and anxiety settled. Conclusions: Nitrous oxide is becoming mor e popular as a recreational drug; its complications should be noted an d a thorough neurological examination performed if abuse is suspected.