Nitrous Oxide Causing Subacute Combined Degeneration: A Case Report

This case report describes a 31-year-old male who developed subacute combined degeneration as a result of vitamin B12 deficiency caused by recreational use of nitrous oxide ("whippets") over a six-month period. nitrous oxide, widely available and often used for its euphoric effects, can lead to alterations in B12 metabolism and decreased myelination, particularly in the dorsal columns, with prolonged use. Despite prompt diagnosis and treatment, including intramuscular B12 injections and physical therapy, he experienced residual weakness and required outpatient rehabilitation. This case highlights the importance of public education about the risks of nitrous oxide abuse, as its use appears to be increasing, in order to prevent further hospitalizations and morbidity.