Lessons of the month: Nitrous oxide-induced functional vitamin B12 deficiency causing subacute combined degeneration of the spinal cord

Seed, Adam; Jogia, Meesha

doi:10.7861/clinmed.2020-0072

Cited by 7 publications

(13 citation statements)

References 6 publications

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“…Case reports with three or more no or unclear ratings were excluded from the thematic analysis (Table 3). Four case reports were excluded because of limited detail about the individual's characteristics, presentation and treatment provided (Edigin, Ajiboye, & Nathani, 2019;Mo Kin Kwok, de Lemos, & Sharaf, 2019;Seed & Jogia, 2020;Wong, Harrison, Mattman, & Hsiung, 2014). 2 Was the patient's history clearly described and presented as a timeline?…”

Section: Case Report Resultsmentioning

confidence: 99%

“…The most common reason (n=11) for receiving a no rating in a JBI item was not clearly describing the patient's history, including the patients' medical, family, and psychosocial history (Assaf et al, 2020;Choi et al, 2019;den Uil et al, 2018;Edigin et al, 2019;Ghobrial et al, 2012;Kim et al, 2019;Mo Kin Kwok et al, 2019;Seed & Jogia, 2020;Wong et al, 2014). Moreover, some reports (n=6) failed to describe the patient characteristics in depth (Assaf et al, 2020;Bajaj et al, 2018;den Uil et al, 2018;Edigin et al, 2019;Ghobrial et al, 2012;Wong et al, 2014).…”

Section: Case Report Resultsmentioning

confidence: 99%

“…There was one report of an individual who injected themselves with B12 on advice of friend which resolved their symptoms (Edigin et al, 2019). However, a third or 29% of people with N₂O problems will not have B12 deficiency (Seed & Jogia, 2020). The most significant limitation of the case reports is that the outcome of medical interventions is not reported.…”

Section: Individualsmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Allan¹,

Cameron²,

Bruno³

2022

Preprint

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Background Nitrous Oxide (N₂O) is a dissociative anaesthetic that is sometimes used recreationally. The prevalence of N₂O use is difficult to quantify but appears to be increasing. Research on N₂O harms and application of harm reduction strategies are limited. The aim of this mixed method systematic review was to collate and synthesise the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. Methods To identify publications reporting recreational use of N₂O, a search of public health, psychology and social science databases was conducted. Databases included PubMed, CIHNAL, PsycINFO, Scopus and Web of Science. Gray literature and Google advanced search were also used. Due to limited published literature on the recreational use of N₂O, no limit was placed on publication date or study type. A thematic synthesis extracted descriptive and analytical themes from the selected studies. Quality appraisal was conducted using the CASP Tool for Qualitative studies and the Joanna Briggs Institute case report assessment tool Results The search retrieved 407 reports. Thirty-four were included in the final analysis including sixteen case reports. The included studies were primarily concerned with raising awareness of the apparently increasing use and subsequently increasing harms of recreational N₂O use. There was limited reference to policy or legislative responses in any published studies, no suggestions for harm reduction strategies or application of service level responses. In general, individuals lack awareness of N2O related harms. Conclusion The review found three key areas that deserve further consideration including: 1) policy, 2) service delivery, and 3) harm associated with N₂O use. We recommend a top-down (policy) and bottom-up (services delivery/services users) approach to harm reduction for N₂O use which also includes further consultation and research with both groups. Future research could explore young people’s experience of N₂O use including benefits and problems to inform contextually relevant harm reduction strategies.

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Section: Case Report Resultsmentioning

confidence: 99%

Section: Case Report Resultsmentioning

confidence: 99%

Section: Individualsmentioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Allan¹,

Cameron²,

Bruno³

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…This is an area that warrants further study. Methylmalonic acid, a more sensitive measure, is grossly elevated in patients presenting with severe nerve and spinal cord toxicity, but again, correlation studies are overall lacking 1,9 . N 2 O inhalation can cause bodily injury from dizziness, imbalance and leg weakness.…”

mentioning

confidence: 99%

“…Methylmalonic acid, a more sensitive measure, is grossly elevated in patients presenting with severe nerve and spinal cord toxicity, but again, correlation studies are overall lacking. 1,9 N 2 O inhalation can cause bodily injury from dizziness, imbalance and leg weakness. Rarer still are asphyxiation and frostbite injuries from cooling discharging N 2 O cylinders.…”

mentioning

confidence: 99%

Whipping up public policy discussion: Australia's problem with recreational nitrous oxide use

Weastell

2022

Internal Medicine Journal

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Nitrous oxide abuse in the emergency practice, and Review of toxicity mechanisms and potential markers

Chevalier-Curt

Grzych

Tard

et al. 2022

Food and Chemical Toxicology

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Lessons of the month: Nitrous oxide-induced functional vitamin B12 deficiency causing subacute combined degeneration of the spinal cord

Cited by 7 publications

References 6 publications

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Whipping up public policy discussion: Australia's problem with recreational nitrous oxide use

Nitrous oxide abuse in the emergency practice, and Review of toxicity mechanisms and potential markers

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