Metabolic encephalopathy caused by nitrous oxide ('laughing gas') induced hyperammonaemia.
BMJ Case Reports November 25, 2019 Marissa Ginette Danielle Vive, Galia Valentinova Anguelova, Sjoerd Duim et al.
A 26-year-old man presented at the emergency department with confusion and decreased consciousness after several days of vomiting. In the preceding 6 months, he had used a 2-litre tank of nitrous oxide (N2O) weekly. His metabolic encephalopathy was caused by hyperammonaemia which probably resulted from interference of N2O-induced vitamin B12 deficiency with ammonia degradation. A catabolic...