{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:03:34Z","timestamp":1790071414936,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Nitrous oxide (N\n                      <jats:sub>2<\/jats:sub>\n                      O) misuse is a growing health concern, with N\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010induced neurological disorders increasingly reported across Europe. Among these, N\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010induced polyneuropathy (PNP) can lead to permanent deficits, yet its neurophysiological characteristics remain inconsistently described. This retrospective case series aimed to characterize the electrophysiological pattern of N\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010induced polyneuropathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We reviewed the records of 12 patients with acute neurological symptoms and a history of N\n                      <jats:sub>2<\/jats:sub>\n                      O abuse, all of whom underwent electrophysiological testing at a German tertiary care hospital between July 2023 and December 2024. Data were analyzed descriptively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Conduction studies revealed evidence of PNP in eight out of 12 patients and the most common pattern was pure motor (5\/8). No distinct clinical phenotype could be identified for patients with electrophysiologically confirmed PNP or Pure\u2010Motor PNP. SSEPs were abnormal in all assessable patients, whereas signs of SCD on MRI were present in a smaller proportion. Only three of 10 tested patients had reduced vitamin B12 levels, while all showed elevated methylmalonic acid (MMA) levels. Mean MMA levels were higher in patients with PNP than in those without.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>\n                      The reason why N\n                      <jats:sub>2<\/jats:sub>\n                      O leads to different patterns of PNP remains unclear and a distinct phenotype for N\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010induced PNP or Pure\u2010Motor PNP was not found in this cohort. MMA represents a more reliable biomarker than serum vitamin B12 in the diagnostic workup of N\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010induced neurotoxicity. These findings highlight the need for further research into additional neurotoxic properties of N\n                      <jats:sub>2<\/jats:sub>\n                      O and individual predisposing factors underlying the different electrophysiological patterns of N\n                      <jats:sub>2<\/jats:sub>\n                      O\u2010induced PNP.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jns.70156","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:29:24Z","timestamp":1785547764000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurophysiological Characteristics of Nitrous Oxide\u2010Induced Polyneuropathy: A Case Series"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8835-9223","authenticated-orcid":false,"given":"Tanya Elisabeth","family":"Bentley","sequence":"first","affiliation":[{"name":"Department of Neurology Hospitals of the City of Cologne  Cologne Germany"},{"name":"Department of Psychiatry University of Cologne, Medical Faculty  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Limmroth","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospitals of the City of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Health Faculty\/Department for Human Medicine University of Witten\/Herdecke  Witten Germany"},{"name":"Lung Clinic Hospitals of the City of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2140-906X","authenticated-orcid":false,"given":"Johannes Fabian","family":"Holle","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospitals of the City of Cologne  Cologne Germany"},{"name":"Health Faculty\/Department for Human Medicine University of Witten\/Herdecke  Witten Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Recreational Use of Nitrous Oxide: A Growing Concern for Europe","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2022"},{"key":"e_1_2_11_3_1","unstructured":"Office for National Statistics Drug Misuse in England and Wales: Year Ending March 2023 https:\/\/www.ons.gov.uk."},{"key":"e_1_2_11_4_1","volume-title":"Monitoring\u2010System Drogentrends (MoSyD) Jahresbericht 2023","author":"Werse B.","year":"2024"},{"key":"e_1_2_11_5_1","unstructured":"Bundesministerium der Justiz Neue\u2010psychoaktive\u2010Stoffe\u2010Gesetz (NpSG) 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