{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:52:07Z","timestamp":1784605927624,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Although several case series have described nitrous\u2010oxide\u2010associated neurological disorders, a comprehensive assessment of exposure characteristics (e.g., time to onset, level of exposure) in substance abusers has not been performed. The aim of this study was to describe the onset patterns of recreational use of nitrous\u2010oxide\u2010induced neurological disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All cases of neurological disorders related to nitrous oxide recreational use reported to the Hauts\u2010de\u2010France addictovigilance center between January 2019 and August 2020 were selected. Only cases requiring hospitalization with informative data to perform the nitrous oxide causality assessment were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 20 cases from five hospitals were included. The male\u2010to\u2010female ratio was 6:1 and the median age was 19\u00a0years (range 16\u201334). The neurological presentation (myeloneuropathy 64%, 7\/11; sensorimotor neuropathy 36%, 4\/11) included for all patients gait disorders due to proprioceptive ataxia and limb hypoesthesia. The median dose used per occasion was 100 cartridges (range 5\u2013960; <jats:italic>n<\/jats:italic>\u00a0=\u00a019). The median time from the start of nitrous oxide use to the onset of neurological symptoms was 6\u00a0months (range 0.7\u201354; <jats:italic>n<\/jats:italic>\u00a0=\u00a016). The cumulative dose was significantly higher in patients with damage to all four limbs than in patients with lower limb symptoms only (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.042).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A low intermittent exposure may be sufficient to cause neurological damage in some subjects, suggesting that, at the population level, there is no safe exposure to nitrous oxide in recreational settings. The severity of neurological impairment could increase once used at high doses and for prolonged durations of nitrous oxide.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15370","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T11:53:37Z","timestamp":1650714817000},"page":"2173-2180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Myeloneuropathy induced by recreational nitrous oxide use with variable exposure levels"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6824-7283","authenticated-orcid":false,"given":"B\u00e9renger","family":"Largeau","sequence":"first","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"Addictovigilance Center (CEIP Hauts\u2010De\u2010France) Univ. 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Lille Inserm CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Sylvie","family":"Caous","sequence":"additional","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"Addictovigilance Center (CEIP Hauts\u2010De\u2010France) Univ. Lille Inserm CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-8090","authenticated-orcid":false,"given":"C\u00e9line","family":"Tard","sequence":"additional","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"Centre de R\u00e9f\u00e9rence des Maladies Neuromusculaires Nord\u2010Est\u2010Ile de France Univ. Lille Inserm CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Carton","sequence":"additional","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"Addictovigilance Center (CEIP Hauts\u2010De\u2010France) Univ. Lille Inserm CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9gory","family":"Kuchcinski","sequence":"additional","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"Neuroradiology Department Univ. Lille Inserm CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Gautier","sequence":"additional","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"PharmacoVigilance Regional Center (CRPV) Univ. Lille Inserm CHU Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Deheul","sequence":"additional","affiliation":[{"name":"Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Inserm, U1172  Lille France"},{"name":"Addictovigilance Center (CEIP Hauts\u2010De\u2010France) Univ. Lille Inserm CHU Lille  Lille France"},{"name":"Poison Control Center Univ. 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