Nitrous oxide-induced subacute combined degeneration of the cord: diagnosis and treatment.
Paris, Alvar Lake, Luke Joseph, Albert Workman, Anna Walton, Joseph Hayton, Tom Evangelou, Nikos Nicholl, David Ayling, Ruth M. Lilleker, James B.
Paris, Alvar
Lake, Luke
Joseph, Albert
Workman, Anna
Walton, Joseph
Hayton, Tom
Evangelou, Nikos
Nicholl, David
Ayling, Ruth M.
Lilleker, James B.
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2023-02-22
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Abstract
Recreational use of nitrous oxide (N2O) has increased rapidly in recent years and is now the second most commonly used recreational drug among young people in the UK. There has been a corresponding rise in cases of nitrous oxide-induced subacute combined degeneration of the cord (N2O-SACD), a pattern of myeloneuropathy usually associated with severe vitamin B12 deficiency. This can cause serious and permanent disability in young people but, if recognised early, may be effectively treated. All neurologists should be aware of N2O-SACD and its treatment; however, there are currently no agreed guidelines. Based on our experience in East London, an area of high N2O use, we provide practical advice on its recognition, investigation and treatment.
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Paris A, Lake L, Joseph A, Workman A, Walton J, Hayton T, Evangelou N, Lilleker JB, Ayling RM, Nicholl D, Noyce AJ. Nitrous oxide-induced subacute combined degeneration of the cord: diagnosis and treatment. Pract Neurol. 2023 Jun;23(3):222-228. doi: 10.1136/pn-2022-003631. Epub 2023 Feb 22. PMID: 36813556; PMCID: PMC10313972.
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