Protracted encephalopathy and subacute combined degeneration associated with chronic nitrous oxide use: a case report (opens in new tab)

Nitrous oxide is a dissociative hallucinogen that is increasingly used recreationally, in part due to its widespread availability. Its use is known to cause subacute combined degeneration via inactivation of vitamin B12; it may also result in acute delirium and chronic progressive encephalopathy. Though current practice guidelines call for treatment of neurological sequelae of nitrous oxide use with vitamin B12 supplementation, a paucity of long-term outcome data limits our ability to guide e...