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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2012-303105
  • Neurological picture

Nitrous oxide-induced myelopathy with inverted V-sign on spinal MRI

  1. Daniel Becker1,2
  1. 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Hugo W Moser Research Institute at Kennedy Krieger Inc, Baltimore, Maryland, USA
  1. Correspondence to Dr Daniel Becker, 716 North Broadway, Room 407, Baltimore, Maryland 21205, USA; beckerd{at}kennedykrieger.org
  1. Contributors Sotirchos: study concept and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content. Saidha: study concept and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content. Becker: study concept and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content, study supervision. All authors have approved the final version of the manuscript.

  • Received 28 April 2012
  • Revised 21 May 2012
  • Accepted 23 May 2012
  • Published Online First 8 July 2012

Case report

A previously healthy 28-year-old male presented with a seven-day history of progressive weakness, numbness and paraesthesias, which initially began in the upper extremities, and subsequently spread to the lower extremities. These symptoms were accompanied by Lhermitte's sign, sexual dysfunction and constipation. Social history was significant for recreational nitrous oxide abuse, characterised by the inhalation of …