Nitrous Oxide-Associated Myelopolyneuropathy-A Case Series

Area of Science:

• Neurology
• Toxicology

Background:

• Nitrous oxide (N2O) is increasingly recognized for its recreational use and associated neurological complications.
• Abuse of N2O can lead to significant neurotoxicity.

Purpose of the Study:

• To investigate the clinical, electrophysiological, and imaging findings in patients with neurological complications from nitrous oxide abuse.
• To highlight the association between N2O abuse and polyneuropathy and myelopathy.

Main Methods:

• Retrospective analysis of clinical, electrodiagnostic, imaging, and serological data from seven patients.
• Evaluation included neurological examinations, nerve conduction studies, electromyography, spinal MRI, and homocysteine level assessment.

Main Results:

• Patients presented with sensory impairment, gait disturbances, weakness, or ataxia, primarily affecting the lower limbs.
• Electrodiagnostic studies revealed predominantly motor neuropathies (axonal, demyelinating, or mixed).
• Spinal MRI showed posterior cervical cord lesions, with some patients also having thoracic lesions. Elevated homocysteine levels were observed in all patients.

Conclusions:

• Nitrous oxide abuse is linked to the development of both polyneuropathy and myelopathy.
• A comprehensive understanding of the clinical and diagnostic aspects is essential for accurate differential diagnosis and effective treatment of N2O-induced neurological damage.