Whip-it Beyond Desserts: Causing Subacute Combined Degeneration - Case Report and Literature Review

Document Type

Journal Article

Publication Date

1-1-2025

Journal

Journal of community hospital internal medicine perspectives

Volume

15

Issue

1

DOI

10.55729/2000-9666.1450

Keywords

Case report; Clinical review; Cobalamin deficiency; Neurological sequelae; Nitrous oxide abuse; Recreational drug use; Spinal cord MRI; Subacute combined degeneration (SCD); Vitamin B12 deficiency; Whip-it cartridges

Abstract

Nitrous oxide (NO) has been increasingly used for recreational purposes due to its dissociative and euphoric properties. Exposure to NO results in the deactivation of in vivo vitamin B, leading to subsequent neurological sequelae due to vitamin B deficiency.7 Current management focuses on cessation of exposure and replacement therapy, yet patients may continue to suffer from permanent neurological damage.12 We report a case of a 50-year-old woman who presented with impaired balance, a subacute decline in mental status, multiple falls, and back pain. She was hospitalized for evaluation of her presenting symptoms and for pain management. The patient's sister helped uncover the patient's misuse of NO via "Whip-it!" cartridges. Physical examination, along with magnetic resonance imaging of the cervical and thoracic spine, confirmed the diagnosis of subacute combined degeneration (SCD), and appropriate treatment was initiated. Our case aims to bring attention to this seemingly harmless recreational drug that continues to regain popularity and its association with brain and nerve damage.13.

Department

Medicine

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