{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:27:48Z","timestamp":1787812068672,"version":"build-2784847793"},"reference-count":5,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2015,2,26]]},"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>\n                    Nitrous oxide is increasingly being used as a recreational drug. Prolonged use of nitrous oxide can have disabling neurological sequelae due to functional inactivation of vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    . We present three cases illustrating the neurological complications of using nitrous oxide. Two of these patients received nitrous oxide as a consequence of repeated hospital attendance and the third via \u2018Whippit\u2019 canisters used in cream dispensers, which are now widely available. Two patients developed sensorimotor peripheral neuropathy with demyelinating features with no clinical or imaging evidence of myelopathy, emphasising that not all patients develop subacute combined degeneration of the spinal cord (the typical presentation of functional vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    deficiency). The diagnosis was based upon the history of nitrous oxide use and raised levels of homocysteine and\/or methylmalonic acid. All patients were treated with parenteral vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    with partial recovery, though two were left significantly disabled.\n                  <\/jats:p>","DOI":"10.1136\/practneurol-2014-001071","type":"journal-article","created":{"date-parts":[[2015,5,14]],"date-time":"2015-05-14T03:53:41Z","timestamp":1431575621000},"page":"207-209","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":125,"title":["Whippits, nitrous oxide and the dangers of legal highs"],"prefix":"10.1136","volume":"15","author":[{"given":"Alexander G","family":"Thompson","sequence":"first","affiliation":[{"name":"Department of Neurology, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Isabel","family":"Leite","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P","family":"Lunn","sequence":"additional","affiliation":[{"name":"MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L H","family":"Bennett","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,5,14]]},"reference":[{"key":"2025090411505050000_15.3.207.1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1213\/00000539-197903000-00009","article-title":"Abuse of nitrous oxide","volume":"58","author":"Rosenberg","year":"1979","journal-title":"Anesth Analg"},{"key":"2025090411505050000_15.3.207.2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S0376-8716(00)00215-5","article-title":"Drugs and the dance music scene: a survey of current drug use patterns among a sample of dance music enthusiasts in the UK","volume":"64","author":"Winstock","year":"2001","journal-title":"Drug Alcohol Depend"},{"key":"2025090411505050000_15.3.207.3","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1213\/00000539-198105000-00003","article-title":"Exposure to Nitrous Oxide and Neurologic Disease among Dental Professionals","volume":"60","author":"Brodsky","year":"1981","journal-title":"Anesth Analg"},{"key":"2025090411505050000_15.3.207.4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1742-6723.2009.01262.x","article-title":"Peripheral neuropathy following nitrous oxide abuse","volume":"22","author":"Richardson","year":"2010","journal-title":"Emerg Med Australas"},{"key":"2025090411505050000_15.3.207.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0967-5868(99)90087-5"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/practneurol-2014-001071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T18:51:00Z","timestamp":1757011860000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/practneurol-2014-001071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,14]]},"references-count":5,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,5,14]]},"published-print":{"date-parts":[[2015,6]]}},"alternative-id":["10.1136\/practneurol-2014-001071"],"URL":"https:\/\/doi.org\/10.1136\/practneurol-2014-001071","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,14]]}}}