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Nitrous oxide-induced myelopathy with inverted V-sign on spinal MRI
  1. Elias S Sotirchos1,
  2. Shiv Saidha1,
  3. 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}

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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 …

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  • Disclosures Dr Sotirchos has no disclosures. Dr Saidha has received consulting fees from Medical Logix for the development of continuing medical education programmes in neurology, and educational grant support from Teva Neurosciences. Dr Becker has no disclosures.

  • Competing interests None.

  • Patient consent The radiological images accompanying the submission are anonymised, and the case report does not contain information that may identify the patient.

  • Provenance and peer review Not commissioned; externally peer reviewed.