Subacute Combined Degeneration of the Spinal Cord From Nitrous Oxide Abuse

The recreational use of nitrous oxide is surging in popularity, with nearly 13 million Americans aged 12 and older reported to have misused it, according to a 2019 survey by the Substance Abuse and Mental Health Services Administration. Prolonged use has been linked to significant neurological deficits, potentially leading to lifelong issues if not treated early.

We present a case of a 38-year-old male with significant neurologic deficits attributed to prolonged nitrous oxide abuse, resulting in subacute combined degeneration of the spinal cord. This condition is characterized by demyelination of dorsal and lateral columns.

The growing recreational use of nitrous oxide, facilitated by its easy availability and lack of regulation, highlights the importance of clinician vigilance in managing associated risks. Neurological symptoms from vitamin B12 deficiency are particularly worrisome. Early intervention is crucial to prevent potential long-term consequences.