Nitrous oxide-induced subacute combined degeneration of the cord: diagnosis and treatment.

Abstract

Recreational use of nitrous oxide (N2O) has increased rapidly in recent years and is now the second most commonly used recreational drug among young people in the UK. There has been a corresponding rise in cases of nitrous oxide-induced subacute combined degeneration of the cord (N2O-SACD), a pattern of myeloneuropathy usually associated with severe vitamin B12 deficiency. This can cause serious and permanent disability in young people but, if recognised early, may be effectively treated. All neurologists should be aware of N2O-SACD and its treatment; however, there are currently no agreed guidelines. Based on our experience in East London, an area of high N2O use, we provide practical advice on its recognition, investigation and treatment.

• Authors: Alvar Paris, Luke Lake, Albert Joseph, Anna Workman, Joseph Walton, Tom Hayton, Nikos Evangelou, James B Lilleker, Ruth M Ayling, David Nicholl, Alastair J Noyce
• Journal: Practical neurology (Pract Neurol) Vol. 23 Issue 3 Pg. 222-228 (Jun 2023) ISSN: 1474-7766 [Electronic] England
• PMID: 36813556 (Publication Type: Journal Article)
• Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Nitrous Oxide
• Vitamin B 12

Topics

• Humans
• Adolescent
• Subacute Combined Degeneration (diagnosis, chemically induced, complications)
• Nitrous Oxide (adverse effects)
• Magnetic Resonance Imaging
• Vitamin B 12 (therapeutic use)
• Vitamin B 12 Deficiency (chemically induced, complications, diagnosis)