• Ron Dabby, Diana Paleacu Kertesz, Ilia Demurchev, Oded Hershkovich, Mira Ginsberg, and Menachem Sadeh.
• Department of Neurology, Wolfson Medical Center, Holon, Israel, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
• Isr Med Assoc J. 2024 May 1; 26 (5): 294298294-298.

BackgroundThe recreational use of nitrous oxide (N2O) has increased in recent years with a noticeable surge in the incidence of nitrous oxide-related myeloneuropathy.ObjectivesTo raise awareness of increasing myeloneuropathy due to recreational nitrous oxide misuse in Israel.MethodsWe conducted a case series documenting the clinical and investigative features of eight patients presenting with nitrous oxide-induced myeloneuropathy who were admitted to our departments.ResultsParesthesia was the chief complaint in all patients, with sensory gait ataxia being a common feature, which was often accompanied by Romberg's sign and mild lower limb weakness. Vitamin B12 levels were below the normal range in seven patients, accompanied by elevated homocysteine and methylmalonic acid levels. Magnetic resonance imaging scans revealed hyperintense signals in the dorsal columns of the cervical spine. All patients improved following vitamin B12 injections.ConclusionsEnhancing awareness, prompting the use of appropriate investigations, and advocating for timely treatment are needed to overcome the risks associated with nitrous oxide misuse.

29 keywords...

hide…