ArticleIrish journal of medical science2026
Nitrous oxide abuse: single centre experience of nitrous oxide induced myeloneuropathy.
Article in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOver the last 3 years, there has been increasing awareness of nitrous oxide-induced myeloneuropathy, particularly among younger patients.
methodsWe conducted a prospective and retrospective case series of patients presenting with nitrous oxide-associated myeloneuropathy to Tallaght University Hospital, between October 2022 and July 2024. Data were gathered regarding clinical presentation, investigations, and management of patients.
resultsEighteen patients were identified (mean age 20 years, 78% male). The most common presenting symptom was paraesthesia (15/18) followed by limb weakness (13/18) and gait impairment (8/18). All patients reported heavy use of inhaled nitrous oxide, with a minority (3/18) also reporting prophylactic use of B12 supplementation. Levels of vitamin B12 were low (4/18) or low normal (7/18) in the majority of patients. Homocysteine was raised in almost all patients in whom it was measured (14/16). Of those cases (16/18) where MR imaging of the spinal cord was available, T2 hyperintensity was noted in the cervical cord in 8/16 cases, and this extended to involve the thoracic cord in five of those cases. Of those who had nerve conduction studies performed (13/18), motor-predominant axonal neuropathy was the most common pattern seen.
conclusionNitrous oxide abuse, and its neurological complications, continue to represent a significant public health concern, with associated burden on neurological services.
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