Nitrous Oxide Abuse-Induced Vitamin B12 Deficiency and Neurological Injury
IntechOpen eBooks May 28, 2026 Li Wang (15202), Sedine Marie Desiree Nina Agbo, Jin Zhang et al.
Recreational use of nitrous oxide (NO) has increased among young people, and while medical use at controlled doses is generally safe, abuse can cause toxicity. The most common consequence is subacute combined degeneration of the spinal cord, often presenting as myeloneuropathy (spinal cord demyelination and peripheral nerve injury). Other reported effects include cognitive, psychiatric, dermatological, gastrointestinal, cardiovascular, and pulmonary disorders. This chapter reviews major neurological impairments from NO abuse—myelopathy, peripheral neuropathy, and cognitive/psychiatric conditions—to raise awareness and help clinicians recognize, investigate, and manage NO-related neurotoxicity.