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Updated: Oct 4, 2025

A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
[Cervical myelopathy due to nitrous oxide inhalation]
Staffan Svensson1, Allan Karbassi2, Magnus Johnsson3
1specialist i allmänmedicin och klinisk farmakologi, Närhälsan Hjällbo vårdcentral, Göteborg.
Recreational nitrous oxide use can cause serious neurological damage, including cervical myelopathy. Early diagnosis and hydroxycobalamin treatment are crucial for recovery from this nitrous oxide-induced condition.
Area of Science:
- Neurology
- Toxicology
Background:
- Recreational nitrous oxide (N2O) use is increasingly prevalent.
- N2O abuse can lead to severe neurological complications due to vitamin B12 deficiency.
Observation:
- A 19-year-old male presented with numbness, stiffness, weakness, and poor balance.
- He reported recent recreational N2O use.
Findings:
- Cervical myelopathy secondary to heavy N2O use was diagnosed.
- Initial treatment with plasmapheresis was unsuccessful; recovery followed hydroxycobalamin (vitamin B12) substitution therapy.
- The patient was diagnosed with hyperhomocysteinemia.
Implications:
- Highlights the neurotoxic effects of recreational N2O.
- Emphasizes the importance of considering N2O abuse in patients with myelopathy.
- Underscores the diagnostic challenges and the efficacy of vitamin B12 therapy.
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