Recreational use of nitrous oxide (N2O) has increased exponentially recently and leads to neurological disorders including subacute combined degeneration of spinal cord. A recent report from European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) showed that the recreational use of nitrous oxide is a growing and major concern for Europe.
For biological monitoring, serum or urine N2O assays are not routinely performed, as they do not allow to ensure a real exposure due to the very short half-life of this gas in the body. Literature links the clinical symptomatology of N2O intoxication to vitamin B12 inactivation. However, isolated serum vitamin B12 assay does not seem to be a suitable marker for assessing N2O intoxication because it is neither sensitive nor specific. So, functional disorder of vitamin B12, characteristic of N2O intoxication, could be explored by two plasma markers: homocysteine and methylmalonic acid (MMA), but literature report inconstant MMA increase in case of N2O consumption. However, alteration of vitamin B12 metabolism cannot explain all pathophysiological processes and remain still poorly understood.
The objective of this webinar is to propose a complete vision of the issue, to present the epidemiology, the clinical outcomes and finally the effectiveness of the biological markers currently used.
