WHEN LAUGHTER GAS NO LONGER BRINGS LAUGHTER

Introduction: Nitrous oxide (N2O), also dubbed the laughing gas or proto, is a gas used therapeutically in the medical field. However, a recreational trend has emerged, involving the inhalation of N2O from culinary capsules or canisters.

Clinical Case: This involves a 23-year-old patient, Hospitalized for psychomotor agitation, the patient has a history of cardiac arrest following extensive inhalation of laughing gas. The patient presented with a manic syndrome that resolved within 2 days. Biological tests returned normal results, including vitamin B12. Brain MRI revealed bilateral bi-fronto-parietal cortical cerebral atrophy. The patient underwent a neurological etiological assessment, which came back normal.

Discussion: The majority of literature reviews on the psychiatric complications of NO2 use have indicated that the most frequent symptoms are delirium, hallucinations, and confusion. The prognosis is often favorable, with symptoms typically resolving under antipsychotic treatment.

Conclusion: The consumption of nitrous oxide is a recreational practice that is on the rise, and especially among young people. With easy access and low cost.Cases of intoxication are increasing with serious medical complications which can lead to death, regardless of the type of exposure.

引言：一氧化二氮（Nitrous oxide, N₂O），俗称笑气或proto，是一种应用于临床治疗的气体。但近年来出现了休闲娱乐使用该气体的趋势：人们会从烹饪用气胶囊或储气罐中吸入一氧化二氮。

临床病例：本次病例涉及一名23岁患者，因精神运动性激越入院。患者既往有大量吸入笑气后出现心脏骤停的病史。患者表现出躁狂综合征，症状在2日内自行缓解。生物学检测结果均正常，包括维生素B12水平。脑部磁共振成像（Magnetic Resonance Imaging, MRI）显示双侧额顶叶皮质脑萎缩。患者接受了神经系统病因学评估，结果未见异常。

讨论：现有关于一氧化二氮使用所致精神并发症的多数文献综述指出，最常见的症状为谵妄、幻觉及意识模糊。其预后通常良好，经抗精神病药物治疗后症状多可缓解。

结论：一氧化二氮的娱乐性使用呈上升趋势，在青年群体中尤为突出。该物质获取便捷且成本低廉，中毒病例不断增多，可引发严重的医学并发症，甚至导致死亡，无论暴露途径为何。