# Nitrous Oxide: No More a Laughing Matter

## TL;DR

Nitrous oxide can cause spinal cord damage, but this case shows rapid recovery after long-term exposure.

## Contribution

This case highlights a rare and prolonged nitrous oxide-induced myelopathy with rapid recovery.

## Key findings

- Prolonged nitrous oxide exposure led to thoracic dorsal column involvement.
- Significant recovery occurred within two months after exposure ceased.
- Genetic factors may influence susceptibility to nitrous oxide-induced spinal cord damage.

## Abstract

Nitrous oxide (N₂O) is an uncommon cause of subacute combined degeneration (SCD) of the spinal cord, typically observed in district general hospitals, with most affected patients being male. A genetic predisposition may contribute to the development of this myelopathy, particularly due to polymorphisms in the gene responsible for vitamin B12 processing. Our case is distinct in its presentation, involving prolonged exposure over two years, thoracic dorsal column involvement, and rapid, significant recovery within two months.