2023-07-29 07:52:03
New Study Reveals the Neurological Effects of Laughing Gas Use
During the 2023 European Academy of Neurology (EAN) conference, a study conducted in the Netherlands shed light on the neurological effects of nitrous oxide, commonly known as laughing gas, use. The study, a retrospective case-based analysis, aimed to understand the complications associated with recreational use of laughing gas.
In recent years, laughing gas has gained popularity as a recreational drug among young people. News reports have highlighted the dangers of laughing gas use, including traffic accidents and public spaces filled with balloons and cartridges. Furthermore, some individuals have reported experiencing neurological symptoms as a result of using laughing gas. In response to these concerns, laughing gas will be added to the list of prohibited substances under the Opium Act in the Netherlands beginning January 2023.
To delve deeper into the neurological complications associated with excessive laughing gas use, three Dutch hospitals collaborated on a research project. The retrospective case study analyzed medical records from these hospitals, focusing on patients’ nitrous oxide use, symptoms, clinical diagnoses, laboratory tests, imaging and electromyography results, treatments, and follow-ups. The study specifically excluded individuals who had used laughing gas as an anesthetic in a medical setting.
The researchers examined a total of 465 medical records from the past six years, with 251 patients exhibiting confirmed neurological symptoms. The median age of the participants was 22, and 63% were male. Additionally, 61% had a migration background, 77% were unemployed, and 29% used laughing gas daily. The median duration of laughing gas use was 11 months, with a median daily intake of 1.6 kg. Surprisingly, no correlation was found between the quantity of laughing gas used and the extent of vitamin B12 deficiency. However, addiction dependence was associated with higher homocysteine levels.
The study identified sensory problems (84%), motor problems (47%), coordination issues (42%), and spinal or extremity pain (31%) as the most common symptoms experienced by participants. The prevailing diagnoses were polyneuropathy (78%), myelopathy (41%), and encephalopathy (14%). Notably, 40% of patients who did not take vitamin B12 supplements were diagnosed with a deficiency. Moreover, almost all patients (90%) exhibited abnormal blood values for vitamin B12, homocysteine, or methylmalonic acid.
Among the patients, 23% were hospitalized due to their symptoms, and 31% were referred to specialist rehabilitation. Treatment included vitamin B12 supplements, although the administration strategy varied. Unfortunately, follow-up data were available for only 41% of patients. Of those who returned, 79% reported partial or complete recovery.
In conclusion, this Dutch multi-center study provided valuable insights into the neurological effects of recreational laughing gas use. The research indicated a high prevalence of polyneuropathy, myelopathy, and encephalopathy among nitrous oxide users. The study also emphasized the significance of functional biomarkers like homocysteine and methylmalonic acid in diagnosis, rather than relying solely on serum vitamin B12 levels. It was further revealed that the duration and quantity of laughing gas use did not correlate with the severity of vitamin B12 deficiency. The study highlighted a concerning trend of patients failing to attend follow-up appointments, underscoring the issue of addiction dependency.
As the use of laughing gas continues to increase, this study serves as a reminder of the potential neurological complications associated with its recreational use.]
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