Episode 194: Nitrous Oxide Toxicity

We review Nitrous Oxide Toxicity: Symptoms, diagnosis, and treatment overview

Hosts:
Stefanie Biondi, MD
Brian Gilberti, MD

Download Leave a Comment Tags: Toxicology Show Notes

Patient Case Illustration

• Hypothetical case: 21-year-old male with no previous medical history, experiencing a month of progressively worsening numbness, tingling, and weakness. Initially starting in his toes and spreading to his hips, and later involving his hands, the symptoms eventually escalated to the point of immobilization. Despite initially denying drug use, the patient admitted to using 40-60 canisters of nitrous oxide (whippets) every weekend for the last three months.

Background and Recreational Use of Nitrous Oxide

• Nitrous oxide, a colorless, odorless gas with anesthetic properties.
• Synthesized in the 18th century.
• Its initial medical purpose expanded into recreational use due to its euphoric effects.
• Resurgence as a recreational drug during the COVID-19 lockdowns.
• Accessibility and legal status.

Public Misconceptions and Health Consequences

• There are widespread misconceptions about nitrous oxide
  • Particularly the belief in its safety and lack of long-term health risks.
  • Contrary to popular belief, frequent use of nitrous oxide can lead to significant, sometimes irreversible, health issues.

Neurological Examination and Diagnosis