INTRODUCTION Recreational use of nitrous oxide (N2O) is a growing practice in France and all around the world and is often associated with neurological complications. We report detailed clinical and paraclinical presentations of 12 patients with combined degeneration of the spinal cord and peripheral neuropathies in relation to N2O consumption, possibly favored by lockdowns due to SARS-CoV-2 pandemic. RESULTS With variable levels of consumption, the 12 patients presented spinal cord and/or peripheral nerve damage, with mostly motor and ataxic symptoms, motor axonal nerve damage, and medullary T2-weighted hyperintensities on MRI. There was a clear improvement in symptoms after vitamin B12 substitution, although some sequelae remained, particularly sensory. DISCUSSION We report detailed clinical, electrophysiological, radiological, and biological consequences of N2O abuse in 12 patients. Our data support the clinical and paraclinical observations reported in the literature. The mechanisms of neurological N2O toxicity are still debated. There is currently no precise recommendation on the therapeutic management. The clinical evolution after vitamin B12 substitution seems sufficient but could depend on early management. Effective messages targeting at risk population, but also the health professionals involved, seem crucial as does a better legal framework for this growing practice.

中文翻译：

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SARS-CoV-2 大流行期间娱乐性一氧化二氮滥用的神经学后果。

引言 一氧化二氮 (N2O) 的娱乐性使用在法国和世界各地越来越普遍，并且通常与神经系统并发症有关。我们报告了 12 名与 N2O 消耗有关的脊髓联合变性和周围神经病变患者的详细临床和临床旁表现，这可能因 SARS-CoV-2 大流行而受到封锁。结果 在不同程度的消耗下，12 名患者出现脊髓和/或周围神经损伤，主要表现为运动和共济失调症状、运动轴突神经损伤和 MRI 上的髓质 T2 加权高信号。维生素 B12 替代后症状明显改善，但仍有一些后遗症，特别是感觉。讨论 我们报告详细的临床、电生理学、放射学、12 名患者滥用 N2O 的生物学后果。我们的数据支持文献中报道的临床和临床旁观察结果。N2O 的神经毒性机制仍有争议。目前还没有关于治疗管理的准确建议。维生素 B12 替代后的临床进展似乎已经足够，但可能取决于早期管理。针对风险人群以及所涉及的卫生专业人员的有效信息似乎至关重要，为这种日益增长的做法提供更好的法律框架也很重要。维生素 B12 替代后的临床进展似乎已经足够，但可能取决于早期管理。针对风险人群以及所涉及的卫生专业人员的有效信息似乎至关重要，为这种日益增长的做法提供更好的法律框架也很重要。维生素 B12 替代后的临床进展似乎已经足够，但可能取决于早期管理。针对风险人群以及所涉及的卫生专业人员的有效信息似乎至关重要，为这种日益增长的做法提供更好的法律框架也很重要。