Lachgas: om te lachen?
Tijdschrift voor Geneeskunde July 11, 2023 M. Cleerens, V. Leenaerts, S. Verelst
Recreational use of nitrous oxide, a legal and readily available gas, is increasingly popular among young people and poses serious medical risks. Unlike medical use where it is mixed with oxygen, recreational inhalation can cause acute hypoxia leading to coordination disorders, loss of consciousness, and headache. Chronic use results in myelo- and neuropathy from functional vitamin B12 deficiency, with motor weakness, gait ataxia, and sensory abnormalities affecting the lower limbs more than upper limbs. Diagnosis relies on history, clinical findings, MRI, and electromyography. Treatment includes vitamin B12, but stopping abuse is essential for recovery. Clinicians should actively inquire about nitrous oxide use when symptoms suggest it.