Neurological complications of excessive recreational nitrous oxide use: a case series based on a text mining algorithm

Background The recreational use of nitrous oxide (N 2 O) has gained popularity over recent years. We present a case series of excessive N 2 O users with neurological complications. Methods In this retrospective three-centre study, we used a text mining algorithm to search for patients who used N 2 O...

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Bibliographic Details
Published in:Journal of neurology 2024-03, Vol.271 (3), p.1267-1276
Main Authors: Ruijter, B. J., de Mooij, M. J., Bruijnes, J. E., van Oosterhout, W. P. J., Kwa, V. I. H.
Format: Article
Language:English
Subjects:
Algorithms
Brain Diseases - chemically induced
Central nervous system diseases
Data mining
Dietary supplements
Electromyography
Encephalopathy
Homocysteine
Humans
Magnetic resonance imaging
Medicine
Medicine & Public Health
Methylmalonic Acid
Neurological complications
Neurology
Neuroradiology
Neurosciences
Nitrous oxide
Nitrous Oxide - adverse effects
Original Communication
Patients
Polyneuropathies - drug therapy
Polyneuropathy
Retrospective Studies
Serum levels
Spinal cord
Spinal Cord Diseases - chemically induced
Spinal Cord Diseases - diagnostic imaging
Spinal Cord Diseases - drug therapy
Vitamin B 12
Vitamin B 12 Deficiency - chemically induced
Vitamin B 12 Deficiency - drug therapy
Vitamin B12
Vitamin deficiency
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Summary:Background The recreational use of nitrous oxide (N 2 O) has gained popularity over recent years. We present a case series of excessive N 2 O users with neurological complications. Methods In this retrospective three-centre study, we used a text mining algorithm to search for patients who used N 2 O recreationally and visited a neurologist. Results We identified 251 patients. The median duration of N 2 O use was 11 months (interquartile range [IQR], 3–24) and the median amount of N 2 O used per occasion 1.6 kg (IQR 0.5–4.0). Clinically, polyneuropathy (78%), myelopathy (41%), and encephalopathy (14%) were the most common diagnoses. An absolute vitamin B12 deficiency of 
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-023-12061-x