{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:41:53Z","timestamp":1771267313709,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T00:00:00Z","timestamp":1668384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Nitrous oxide (N<jats:sub>2<\/jats:sub>O), commonly known as laughing gas, is widely used in clinical practice and food industry. However, an increasing number of young people have been abusing N<jats:sub>2<\/jats:sub>O for recreational purpose, resulting in many functional disorders and sometimes irreversible nerve damage. We present the case of a 20-year-old N<jats:sub>2<\/jats:sub>O abuser who gradually developed peripheral neuropathy after continuously inhaling N<jats:sub>2<\/jats:sub>O for 2 months. The neurological symptoms of the patient had kept exacerbation for the next 2 months until she came for medical care sitting in a wheelchair. We suggested the patient halting N<jats:sub>2<\/jats:sub>O intake and supplementing methylcobalamine according to the standardized protocol. Her symptoms had partly recovered during the following 2 weeks but remained unchanged in another 2 weeks. Antibodies against ganglioside complexes were detected and anti-GM1 IgM antibodies were positive in both cerebrospinal fluid and serum. Intravenous immunoglobulin was given as an additional treatment and the patient's symptoms had significantly recovered further. The patient discharged walking by herself. Then she has been continuously followed up in outpatient department for the next 4 months and taking steroid hormone as well as methylcobalamine. Her symptoms gradually disappeared and all the electrophysiological parameters significantly improved. With this case we were able to show that N<jats:sub>2<\/jats:sub>O-related peripheral neuropathy is not only a metabolic disorder but also an immune-mediated disease. N<jats:sub>2<\/jats:sub>O intake can trigger a mimic Guillain-Barr\u00e9 syndrome.<\/jats:p>","DOI":"10.3389\/fneur.2022.1033327","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T06:33:40Z","timestamp":1668407620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Case report: Recreational nitrous oxide abuse triggered peripheral neuropathy possibly through the immune-mediated pathogenesis"],"prefix":"10.3389","volume":"13","author":[{"given":"Mei-Xue","family":"Dong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Feng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5237","DOI":"10.3390\/ijerph19095237","article-title":"Recreational nitrous oxide use and associated factors among health profession students in France","volume":"19","author":"Inquimbert","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1177\/0269881116632375","article-title":"Up: the rise of nitrous oxide abuse. An international survey of contemporary nitrous oxide use","volume":"30","author":"Kaar","year":"2016","journal-title":"J Psychopharmacol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"977","DOI":"10.2147\/NDT.S236939","article-title":"Clinical, electrophysiological and radiological features of nitrous oxide-induced neurological disorders","volume":"16","author":"Bao","year":"2020","journal-title":"Neuropsychiatr Dis Treat."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2173","DOI":"10.1111\/ene.15370","article-title":"Myeloneuropathy induced by recreational nitrous oxide use with variable exposure levels","volume":"29","author":"Largeau","year":"2022","journal-title":"Eur J Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1007\/s12640-021-00352-y","article-title":"Recreational nitrous oxide abuse: prevalence, neurotoxicity, and treatment","volume":"39","author":"Xiang","year":"2021","journal-title":"Neurotox Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"704","DOI":"10.3389\/fneur.2019.00704","article-title":"Elucidating unique axonal dysfunction between nitrous oxide abuse and vitamin B12 deficiency","volume":"10","author":"Tani","year":"2019","journal-title":"Front Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e2533","DOI":"10.1002\/brb3.2533","article-title":"Analysis of clinical characteristics and prognostic factors in 110 patients with nitrous oxide abuse","volume":"12","author":"Yu","year":"2022","journal-title":"Brain Behav."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e2416","DOI":"10.1002\/brb3.2416","article-title":"Clinical epidemiological characteristics of nitrous oxide abusers: a single-center experience in a hospital in China","volume":"11","author":"Li","year":"2021","journal-title":"Brain Behav."},{"key":"B9","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1177\/1941874420910648","article-title":"An acute, severe axonal sensorimotor polyneuropathy in the setting of nitrous oxide abuse","volume":"10","author":"Beal","year":"2020","journal-title":"Neurohospitalist."},{"key":"B10","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1080\/01616412.2021.1935101","article-title":"Electrophysiological characteristics of patients with nitrous oxide abuse","volume":"43","author":"Li","year":"2021","journal-title":"Neurol Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e2402","DOI":"10.1002\/brb3.2402","article-title":"Nitrous oxide-related neurological disorders: clinical, laboratory, neuroimaging, and electrophysiological findings","volume":"11","author":"Jiang","year":"2021","journal-title":"Brain Behav."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2720","DOI":"10.1007\/s00415-021-10858-2","article-title":"Nitrous oxide-induced predominantly motor neuropathies: a follow-up study","volume":"269","author":"Berling","year":"2022","journal-title":"J Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e158524","DOI":"10.1172\/JCI158524","article-title":"Schwann cell nodal membrane disruption triggers bystander axonal degeneration in a Guillain-Barr\u00e9 syndrome mouse model","volume":"132","author":"McGonigal","year":"2022","journal-title":"J Clin Investig"},{"key":"B14","doi-asserted-by":"publisher","first-page":"147","DOI":"10.3390\/ijms21010147","article-title":"On-membrane dynamic interplay between anti-GM1 IgG antibodies and complement component C1q","volume":"21","author":"Yanaka","year":"2019","journal-title":"Int J Mol Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2570","DOI":"10.3906\/sag-2101-348","article-title":"Serum anti-ganglioside antibodies in patients with autoimmune limbic encephalitis","volume":"51","author":"Oktar","year":"2021","journal-title":"Turk J Med Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1080\/08923973.2020.1735412","article-title":"A. review of the effects of the anesthetic gas nitrous oxide on the immune system; 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