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Nitrous oxide induced neurotoxicity: a case report and literature review
  • Darmiga Thayabaran,
  • Daniel Burrage
Darmiga Thayabaran
Whittington Health NHS Trust
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Daniel Burrage
Whittington Health NHS Trust
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Abstract

Nitrous oxide is an increasingly popular recreational drug. However recurrent or prolonged use can be associated with nitrous oxide toxicity, with numerous reports of harm documented in the literature. Nitrous oxide irreversibly binds and inactivates vitamin B12, which is an important co-factor in metabolic pathways involved in DNA and myelin synthesis. Toxicity is therefore associated with vitamin B12 deficiency-related syndromes, primarily involving haematological and neurological systems. As a ‘legal high’, nitrous oxide use has attracted repeated health warnings from experts. An awareness and understanding of the pathophysiology and management of nitrous oxide toxicity is therefore important for clinicians. We discuss the case of a 29-year old man presenting with nitrous oxide-induced sensorimotor neuropathy and review the existing literature surrounding toxicity.

Peer review status:Published

14 Oct 2020Submitted to British Journal of Clinical Pharmacology
15 Oct 2020Submission Checks Completed
15 Oct 2020Assigned to Editor
19 Oct 2020Reviewer(s) Assigned
23 Nov 2020Review(s) Completed, Editorial Evaluation Pending
25 Nov 2020Editorial Decision: Revise Minor
07 Dec 20201st Revision Received
09 Dec 2020Submission Checks Completed
09 Dec 2020Assigned to Editor
09 Dec 2020Review(s) Completed, Editorial Evaluation Pending
10 Dec 2020Reviewer(s) Assigned
04 Feb 2021Editorial Decision: Accept
16 Feb 2021Published in British Journal of Clinical Pharmacology. 10.1111/bcp.14779