Clinical Feature and Sural Biopsy Study in Nitrous Oxide-induced Peripheral Neuropathy

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2022 Sep 16

PMID 36112660

Authors

Qian Wang

Xiaohui Duan

Mingrui Dong

Shaojie Sun

Pan Zhang

Fang Liu

Li Wang

Renbin Wang

Affiliations

Soon will be listed here.

Abstract

Objective: The objective was to analyze the clinical characteristics and pathological characteristics of sural biopsy in nitrous oxide (N2O) -induced peripheral neuropathy.

Methods: We recruited 18 patients with N2O abuse-induced neurological disorders and reported their demographic data, clinical manifestations, laboratory examinations, and nerve conduction studies. Seven patients underwent sural nerve biopsy pathologic examination.

Results: All 18 patients had polyneuropathy, the nerve conduction results showed significant reductions in motor and sensory amplitudes, slowing of conduction velocities, and prolongation of latencies in most tested nerves compared to the controls. Toluidine blue staining of semi-thin sections of sural nerve biopsy showed decreased myelinated nerve fiber density, increased thin myelinated nerve fiber density, and axonal regeneration. Electron microscopy showed axonal degeneration and nerve regeneration.

Conclusion: The main manifestations of peripheral nerve damage caused by the abuse of N2O are lower limb weakness and distal sensory disorder. The nerve conduction study results demonstrated that mixed axonal and demyelinating neuropathy was the most common type of neuropathy. Sural biopsy showed the main pathological change was chronic axonal degeneration.

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