Title: Physical exam findings in chronic nitrous oxide abuse<br/>Author: Hong Kim<br/><a href='http://umem.org/profiles/faculty/526/'>[Click to email author]</a><hr/><p>
</p>
<p>
What physical exam findings are associated with nitrous oxide abuse?</p>
<p>
</p>
<p>
</p>
<p>
</p>
<p>
</p>
<p>
Nitrous oxide (NO) inhalation abuse, also called “whip-its” or “whippets”, inactivates vitamin B12 and create a vitamin B12 deficiency state. Chronic abuse of nitrous oxide can result in neurologic deficits/findings affecting the posterior/dorsal column of the spinal cord. </p>
<p>
Physical exam findings: </p>
<ol>
<li>
Truncal ataxia</li>
<li>
Decreased vibratory sensation and proprioception in lower extremities</li>
<li>
Impaired coordination and rapid alternative movements</li>
<li>
Lhermitte’s sign: paresthesia of the upper and lower extremities associated with flexion of the head/neck.</li>
<li>
Rossolimo’s sign: exaggerated flexion of the toes when the tips of the toes are percussed</li>
</ol>