Abstract
The pattern of degeneration induced in the spinal cords and peripheral nerves of 4 monkeys exposed to nitrous oxide resembles subacute combined degeneration found in man with untreated vitamin B12 deficiency. Our findings indicate that nitrous oxide directly inhibits the folate dependent methionine synthetase reaction. This ultimately results in ‘methyl group deficiency’ with consequent defective remethylation of essential constituents of nerve tissue. The implications of the methyl group deficiency hypothesis are examined and its relationship to the haematological and neurological status of patients with vitamin B12 deficiency are discussed.
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