Nitrous oxide-related neurological disorders: Clinical, laboratory, neuroimaging, and electrophysiological findings.
Brain and behavior December 1, 2021 Jiwei Jiang, Xiuli Shang, Xiaoting Wang et al.
Recreational nitrous oxide (N2O) abuse can cause neurological damage in young people, often overlooked clinically. In 63 patients (average age 22.6 years), the main symptoms were sensory disturbance, followed by gait problems and pyramidal tract damage. Lower initial vitamin B12 levels correlated with more severe clinical impairment, though this link weakened after adjusting for other factors. Spinal MRI abnormalities were not tied to clinical severity but were independently associated with less than six months between first N2O use and hospitalization. Anxiety and depression affected 60% and 63% of patients, respectively, and their severity increased with higher clinical scores and serum homocysteine levels.