A 32-year-old man presented with a 6-week history of tingling in his arms and legs and a 2-week history of inability to walk. A positive Romberg test, sensory ataxia, impaired proprioception and vibratory sensation, and preserved nociception were noted. Magnetic resonance imaging of the whole spine showed hyperintensity in the posterior spinal cord from C1 to T12 and hyperintense lesions in the dorsal column on T2-weighted images. A vitamin B12 level was 107 pg per ml (reference value, >231) without macrocytic anemia. Toxicity of which of the following is the most likely cause of this presentation?
A.Copper
B.Nitrous oxide
C.Organophosphates
D.Tetrodotoxin (pufferfish poisoning)
E.Thallium
答案解析：
正确答案是一氧化二氮。 诊断为与使用一氧化二氮相关的亚急性联合变性。 就诊前两个月，患者开始每天吸入一氧化二氮——也称为“whippets”或“笑气”。 治疗包括停止使用一氧化二氮和氰钴胺替代疗法。 在 4 周的随访中，他能够独立行走。
正确答案：B
原创文章（本站视频密码：66668888），作者：xujunzju，如若转载，请注明出处：https://zyicu.cn/?p=13751
微信扫一扫 
支付宝扫一扫 