Nitrous Oxide: No More a Laughing Matter

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.