Article
Clinical Neurology
Berenger Largeau, Arnaud Karam, Camille Potey, Anne-Sylvie Caous, Celine Tard, Louise Carton, Gregory Kuchcinski, Sophie Gautier, Sylvie Deheul, Regis Bordet
Summary: This study investigated the onset patterns of neurological disorders caused by nitrous oxide abuse and found that even low intermittent exposure could lead to neurological damage. There is no safe level of exposure to nitrous oxide in recreational settings.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
B. J. Ruijter, M. J. de Mooij, J. E. Bruijnes, W. P. J. van Oosterhout, V. I. H. Kwa
Summary: This study reports a case series of excessive N2O users with neurological complications, including polyneuropathy, myelopathy, and encephalopathy. Testing for serum levels of vitamin B12, homocysteine, and methylmalonic acid may support the clinical diagnosis. Treatment should incorporate vitamin B12 supplementation and strategies to prevent relapses in N2O use.
JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Grace Swart, Christopher Blair, Zhong Lu, Solomon Yogendran, Joanna Offord, Emily Sutherland, Stephanie Barnes, Natalie Palavra, Phillip Cremer, Samuel Bolitho, Gabor Michael Halmagyi
Summary: Nitrous oxide misuse can lead to severe but potentially reversible subacute myeloneuropathy. Serum and active B12 levels may be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Neurological deficits can improve with abstinence and B12 supplementation, even in the most severely affected patients.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Article
Medicine, General & Internal
Jessica Redmond, Belinda Cruse, Lynette Kiers
Summary: Neurological complications resulting from nitrous oxide (N2O) abuse, such as subacute paraesthesia and ataxia, are becoming more common in Australia. This study identified a demographic distribution consisting of socially isolated international university students and local residents with a history of mental illness and polydrug abuse who are at increased risk. Low serum vitamin B-12 levels and spinal magnetic resonance imaging consistent with subacute combined degeneration were found in many patients. Public health measures are needed to limit the availability of N2O and educate adolescents and young adults about its potential harm.
INTERNAL MEDICINE JOURNAL
(2022)
Article
Medicine, General & Internal
William P. Schmitt, Saurabh Rohatgi, Marcelo Matiello
Summary: A 33-year-old man presented with progressive worsening paresthesia in the arms and legs. The sensory function was impaired in the arms and legs, and there was absence of reflexes in the legs. A diagnostic test was conducted.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Clinical Neurology
Etienne Fortanier, Edouard Berling, Adrien Zanin, Adrien Le Guillou, Joelle Micaleff, Guillaume Nicolas, Pierre Lozeron, Shahram Attarian
Summary: The recreational use of nitrous oxide (N2O) has led to an increase in cases of acute sensorimotor tetraparesis, known as nitrous oxide-induced neuropathy (N(2)On). This study found that a vitamin B12 serum level < 200 pmol/L and conduction blocks in the initial electrophysiological study are the most sensitive biomarkers for distinguishing between N(2)On and Guillain-Barre syndrome (GBS) patients.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Medicine, General & Internal
Joshua Strauss, Syed F. Qadri
Summary: Nitrous oxide abuse can lead to vitamin B12 deficiency and subsequent neurological complications; despite some studies reporting subacute combined degeneration of the spinal cord caused by N2O abuse, the topic remains controversial among neurologists.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Clinical Neurology
Hui Gao, Ruihan Wang, Yan Zeng, Linyuan Qin, Hanlin Cai, Dong Zhou, Qin Chen
Summary: A retrospective study of 20 hospitalized patients found that the recreational use of nitrous oxide (N2O) is associated with severe neurological impairments. Common symptoms included unsteady gait, weakness, and limb paresthesia, while decreased deep tendon reflexes, reduced muscle strength, and impaired coordination were frequently observed. Factors such as admission from the emergency room, decreased hemoglobin, decreased red blood cell count, and increased mean corpuscular volume were positively correlated with the degree of neurological impairment.
FRONTIERS IN NEUROLOGY
(2023)
Review
Pharmacology & Pharmacy
Sowjanya Mudimela, Narahari Koppa Vishwanath, Anilkumar Pillai, Rodrigo Morales, Sean P. Marrelli, Tatiana Barichello, Vijayasree V. Giridharan
Summary: Research on the gut microbiome and its metabolites, such as trimethylamines (TMA), trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), branched-chain amino acids (BCAAs), bile acids, tryptophan, and indole derivatives, has attracted significant attention in the past three decades. These metabolites, including TMAO, play a role in brain development, neurogenesis, and behavior by crossing the blood-brain barrier (BBB). The composition of the gut microbiota is influenced by various factors, and altered TMAO levels have been associated with metabolic, vascular, psychiatric, and neurodegenerative disorders. This review focuses on the impact of altered TMAO levels on oxidative stress, microglial activation, neuronal apoptosis, neuroinflammation, and the development of psychiatric, cognitive, and behavioral disorders.
DRUG DISCOVERY TODAY
(2022)
Review
Clinical Neurology
Danilo Tornabene, Paola Bini, Matteo Gastaldi, Elisa Vegezzi, Carlo Asteggiano, Enrico Marchioni, Luca Diamanti
Summary: This study aims to investigate the presentation, complications, management, and outcomes of copper deficiency-induced neurological pathologies due to Wilson disease overtreatment. A literature review identified 10 additional cases of neurological pathology resulting from copper deficiency in the context of Wilson disease over-treatment, with myelopathy and peripheral neuropathy being the most common complications.
NEUROLOGICAL SCIENCES
(2023)
Article
Public, Environmental & Occupational Health
Marylene Guerlais, Aurelie Aquizerate, Arthur Lionnet, Amelie Daveluy, Melanie Duval, Marie Gerardin, Marion Istvan, Edouard-Jules Laforgue, Caroline Victorri-Vigneau
Summary: Nitrous oxide has become a public health problem in many countries. France has a dedicated health monitoring system for the abuse and dependence of psychoactive substances, including nitrous oxide. A national survey in France shows an exponential increase in nitrous oxide cases since 2019, with changes in characteristics such as increased proportion of women, higher quantities consumed, and negative evolutions in contexts of use. The main effects include substance use disorders, neurological disorders, psychiatric symptoms, and cardiovascular events. It is important for clinicians to consider nitrous oxide in young patients with various manifestations and to emphasize the importance of stopping consumption.
FRONTIERS IN PUBLIC HEALTH
(2023)
Article
Clinical Neurology
Maximilian Einsiedler, Paul Voulleminot, Stanislas Demuth, Pauline Kalaaji, Thomas Bogdan, Lucas Gauer, Cecile Reschwein, Aleksandra Nadaj-Pakleza, Jerome de Seze, Laurent Kremer, Ivana Schroder, Kevin Bigaut
Summary: This study highlights an increased incidence of neurological complications related to nitrous oxide abuse during the recent COVID-19 lockdown. Patients with compatible neurological symptoms and elevated homocysteinemia should be tracked down and supplemented with vitamin B-12 upon diagnosis.
JOURNAL OF NEUROLOGY
(2022)
Review
Medicine, General & Internal
Ventzislav Bonev, Mark Wyatt, Matthew J. J. Barton, Michael A. A. Leitch
Summary: Nitrous oxide abuse can cause severe sensorimotor polyneuropathy and cervical myelopathy due to vitamin B-12 deficiency. A literature review and case study highlight the harmful effects of recreational nitrous oxide inhalation on the central and peripheral nervous systems.
CLINICAL CASE REPORTS
(2023)
Article
Geosciences, Multidisciplinary
Weiyi Tang, Amal Jayakumar, Xin Sun, John C. Tracey, Julia Carroll, Elizabeth Wallace, Jenna A. Lee, Levy Nathan, Bess Ward
Summary: The study found that N2O consumption rates are high in the seasonally anoxic environment of Chesapeake Bay, but generally undetectable in oxygenated waters. However, when the oxygen concentration was reduced in oxygenated samples, N2O consumption rates increased significantly, indicating the potential for N2O consumption in oxygenated environments. These new observations provide insights into N2O cycling processes and can be used to improve the modeling of N2O flux in estuaries.
GEOPHYSICAL RESEARCH LETTERS
(2022)
Article
Medicine, General & Internal
Larissa Check, Nardine Abdelsayed, Gabriela Figueroa, Aditya Ragunathan, Mohamed Faris
Summary: This case report describes a young hunter who developed subacute combined degenerative disease due to depleted vitamin B12 as a result of recreational inhaled nitrous oxide abuse. The patient experienced complete resolution of symptoms after cessation of nitrous oxide abuse and three months of B12 replacement therapy.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)