Recreational Nitrous Oxide Abuse: Prevalence, Neurotoxicity, and Treatment.

Nitrous oxide (NO), also known as "laughing gas," is a colorless, nonirritating gas. Clinically, it is widely used as an inhaled anesthetic, analgesic, and anxiolytic. In recent years, recreational abuse of NO has become increasingly common, especially among young adults and adolescents, but many of them lack awareness of the possible side effects associated with this drug. NO abuse can damage multiple systems, especially the nervous system, but the exact mechanism of NO toxicity remains controversial. At present, an increasing number of cases of nervous system damage caused by NO abuse have been reported both at home and abroad. Discontinuation of NO use and timely supplementation with vitamin B12 are essential for a good prognosis. Long-term abuse without timely treatment will eventually lead to irreversible neurological damage. In this article, we discuss the epidemiology of NO abuse, neurotoxicity mechanisms, clinical manifestations, relevant auxiliary examinations, treatments, and prognosis to improve social awareness of NO exposure risk, especially among users and clinicians.