Epidemiology of Neurological Complications to Nitrous Oxide Poisoning

NCT ID: NCT05329909

Last Updated: 2022-08-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

135 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-04-10

Study Completion Date

2022-08-31

Brief Summary

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N2O inactivates vitamin B12, impairing its ability to act as a cofactor of methionine synthase. In addition, the elimination of vitamin B12 is increased. Neurological damage is similar to that described in combined sclerosis of the marrow, and are probably related to induce vitamin B12 deficiency. The use of N2O can then precipitate the rapid appearance of signs (neurological, psychiatric and hematological) related to a true and/ or functional vitamin B12 deficiency.

In 1978, RB Layzer described the first 3 cases of peripheral neuropathy secondary to nitrous oxide (N2O) consumption. In 2016, a team collected the 91 published cases: among these, 72 had neurological complications, and 52 had a concentration of vitamin B12 considered "low" or "normal-low"

Since then, consumption patterns seem changed due to: an increasing ease of access, the change of container (packaging in cartridge 8 grams versus bottle of 600 grams) and a usually occasional and festive consumption that seems to become solitary and regular, This change in consumption patterns is explained by an increased incidence of neurological complications, although no epidemiological work is yet available.

The objective of this work is to describe the epidemiology of this condition, to correlate it with major recent social phenomena (confinement related to the SARS-Cov2 pandemic), and finally to compare the incidence of myelopathies secondary to N2O with the incidence of other frequent inflammatory neurological diseases (autoimmune myelitis and Guillain-Barré syndrome).

Detailed Description

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Conditions

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Neurology Department

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Adult patient (≥16 years)
* Hospitalized or having consulted with the departments of Neurology or Internal Medicine for neurological phenomena related to the consumption of N2O. The neurological phenomena included are usually: neuropathies or myelopathies, However, the existence of other neurological or psychiatric signs is not a factor of exclusion: for example, headaches or cognitive or psychiatric disorders with acute onset.
* Exposure to N2O for recreational or medical reasons (Meopa anesthesia).
* Lack of alternative diagnosis other than N2O poisoning
* Consultation for neurological disorders between 01/01/2018 and 31/12/2021

Exclusion Criteria

* Minor subjects or subjects subject to a legal protection measure (guardianship, curators) during the consultation.
* Refusal to include in a study explained in the file
* Absence of N2O consumption during the 6 months preceding the appearance of signs
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier de Saint-Denis

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hôpital DELAFONTAINE

Saint-Denis, Île-de-France Region, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Mickael BONNAN, MD

Role: CONTACT

01 42 35 62 97

Thomas DE BROUCKER, MD

Role: CONTACT

01 42 35 62 97

Facility Contacts

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Stéphanie Cossec

Role: primary

0142356140 ext. 6962

References

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Layzer RB, Fishman RA, Schafer JA. Neuropathy following abuse of nitrous oxide. Neurology. 1978 May;28(5):504-6. doi: 10.1212/wnl.28.5.504.

Reference Type BACKGROUND
PMID: 205816 (View on PubMed)

Sanders RD, Weimann J, Maze M. Biologic effects of nitrous oxide: a mechanistic and toxicologic review. Anesthesiology. 2008 Oct;109(4):707-22. doi: 10.1097/ALN.0b013e3181870a17.

Reference Type BACKGROUND
PMID: 18813051 (View on PubMed)

Garakani A, Jaffe RJ, Savla D, Welch AK, Protin CA, Bryson EO, McDowell DM. Neurologic, psychiatric, and other medical manifestations of nitrous oxide abuse: A systematic review of the case literature. Am J Addict. 2016 Aug;25(5):358-69. doi: 10.1111/ajad.12372. Epub 2016 Apr 1.

Reference Type BACKGROUND
PMID: 27037733 (View on PubMed)

Vollhardt R, Mazoyer J, Bernardaud L, Haddad A, Jaubert P, Coman I, Manceau P, Mongin M, Degos B. Neurological consequences of recreational nitrous oxide abuse during SARS-CoV-2 pandemic. J Neurol. 2022 Apr;269(4):1921-1926. doi: 10.1007/s00415-021-10748-7. Epub 2021 Aug 21.

Reference Type BACKGROUND
PMID: 34417869 (View on PubMed)

Other Identifiers

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2022-A00718-35

Identifier Type: REGISTRY

Identifier Source: secondary_id

CHSD_0023_NEURO

Identifier Type: -

Identifier Source: org_study_id

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