Recreational nitrous oxide abuse causing B12 deficiency with subacute combined degeneration of the spinal cord: A case report

The recreational use of nitrous oxide (N 2 O) is a growing public health concern. Increasing numbers of young individuals are presenting to accident emergency departments complaining of adverse neurological symptoms as a result of N 2 O induced vitamin B12 deficiency. Despite its increasing popularity, many are still not aware of its devastating potential to cause a myriad of severe longstanding neurological impairment. Herein we present a case that highlights the effects of N 2 O abuse and the best way to investigate and manage such patients.