Diagnosis and Management of Nitrous Oxide Poisoning: A Case Report

Abstract

Background: Chronic nitrous oxide (N2O) poisoning induces irreversible inactivation of vitamin B12, affecting two biochemical reactions essential for the proper functioning of the body. The prognosis is excellent when adequately and quickly treated. We present the case of a 23-year-old Caucasian woman with symptoms caused by chronic N2O inhalation.

Case Presentation: A 23-year-old Caucasian woman was admitted to the emergency department with complaints of confusion and gait disturbance. Following an in-depth history and laboratory tests, chronic N2O poisoning was confirmed, and vitamin B12 supplementation was initiated promptly.

Conclusion: Our case demonstrated the clinical presentation and biological changes typical of N2O poisoning. The misuse of N2O is prevalent due to the easy accessibility of cylinders over-the-counter since a few years. Recreational misuse of N2O has been observed in young populations. It is important to raise awareness among emergency physicians and nursing staff regarding increases in their consumption. Treatment involved vitamin B12 supplementation and long-term addiction monitoring.