Inhaled Nitrous Oxide ‘Whip-Its!’ Causing Subacute Combined Degeneration of Spinal Cord

Mohammed Al-Sadawi¹, Hidalgo Claris², Chinyere Archie¹, Apoorva Jayarangaiah³, Modupe Oluya¹ and Samy I. McFarlane^1,

¹Department of Internal Medicine, State University of New York: Downstate Medical Center, Brooklyn, New York, United States-11203

²Department of Internal Medicine, Brooklyn Campus of the VA NY Harbor Healthcare System, Brooklyn, New York, United States-11209

³Department of Internal Medicine, NYC Health and Hospitals/Jacobi Medical Center, Bronx, New York, U.S.A-10461

Cite this paper

Mohammed Al-Sadawi, Hidalgo Claris, Chinyere Archie, Apoorva Jayarangaiah, Modupe Oluya and Samy I. McFarlane. Inhaled Nitrous Oxide ‘Whip-Its!’ Causing Subacute Combined Degeneration of Spinal Cord. American Journal of Medical Case Reports. 2018; 6(12):237-240. doi: 10.12691/AJMCR-6-12-3

Abstract

The opioid prescription drug epidemic is not the only challenging drug abuse that the United States is facing. Over the past decade, the prevalence of another substance of abuse has dramatically; increased that is nitrous oxide, also known as ‘Whip-its’. As per the Substance Abuse and Mental Health Administration, there were twelve million users reported in 2012. Whip-its has become a popular trend among teenagers and young adults, as it is easily accessible. ‘Whip-Its!’ canisters containing nitrous oxide are available for purchase at grocery stores, on the internet, and various retailers without any age limit, warning or regulations. Reported cases of ‘Whip-its’ use have been linked to loss of consciousness, anoxic brain injury, cardiac arrest, and death. Yet, another result of chronic nitrous oxide abuse is that of spinal cord myelopathy due to vitamin B 12 deficiency. In this report we present a case of a 22-year-old male with daily abuse of inhaled nitrous oxide in the form of ‘Whip-its’, who presented with initial symptoms of presumed drug induced psychosis and gradually developed neurological focal deficits, and findings of sensorimotor peripheral neuropathy with myelopathy of the cervical spine and vitamin B12 deficiency.

Keywords

substance abuse, whip-its, subacute combined degeneration of spinal cord

Copyright

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