Nitrous Oxide-Induced Vitamin B12 Deficiency Resulting in Myelopathy

Nitrous oxide, primarily used in the medical field and in the food industry, can cause symptoms of euphoria and analgesia. Recreational use of nitrous oxide is rising, as are reports of its adverse effects, including neurologic complaints secondary to an evoked vitamin B12 deficiency. We outline a case of a patient presenting with several neurologic symptoms and found to have myelopathy secondary to vitamin B12 deficiency in the presence of prolonged recreational nitrous oxide use.