Journal of Neurology

, Volume 239, Issue 7, pp 401–403 | Cite as

Methionine in the treatment of nitrous-oxide-induced neuropathy and myeloneuropathy

  • Charles B. Stacy
  • Alessandro Di Rocco
  • Randall J. Gould
Original Communications


Two cases of severe myeloneuropathy and macrocytic anemia associated with a low serum level of vitamin B12 after prolonged exposure to nitrous oxide are reported. In both cases, the neurological manifestations worsened initially despite B12 supplementation, al though in one case the use of methionine seemed to arrest the progression of the disease and accelerate recovery. This offers further support for the biochemical hypothesis of methionine synthetase inhibition by nitrous oxide and reproduces in man previously reported animal studies with methionine. Methionine may be an important first-line therapy in the initial treatment of neuropathy and myeloneuropathy induced by nitrous oxide, and has a hypothetical role in the treatment of subacute combined degeneration of the cord.

Key words

Nitrous oxide Vitamin B12 Subacute combined degeneration Methionine Myeloneuropathy 


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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Charles B. Stacy
    • 1
  • Alessandro Di Rocco
    • 1
  • Randall J. Gould
    • 2
  1. 1.Department of NeurologyThe Mount Sinai Medical CenterNew YorkUSA
  2. 2.Department of MedicineBeth Israel Medical CenterNew YorkUSA

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