Nitrous Oxide, which is also called laughing gas, now ranks as the 7th most popular drug in the world. Nitrous oxide mainly disturbs B12 metabolism and damages nerves, followed by apparent neuropsychiatric symptoms. It's beneficial to the prognosis of patients if we identify and treat their symptoms early. This case report describes a 19-year-old male who presented with auditory hallucination, persecutory delusions and unstable emotions after abuse of nitrous oxide over the course of half a year. Moreover, neurological signs such as weakness and hyperesthesia also appeared. After supplementation of vitamin B12, the neuropsychiatric symptoms improved, while the lower extremities achieved partial recovery. Therapeutically, we should pay attention to nerve repair, motivation enhancement and reinforce interventions that prevent relapse.
一氧化二氮，俗称“笑气”，已经成为全球第七大滥用药物。“笑气”吸食后影响维生素B12代谢，造成神经损伤，产生显著的精神神经症状。对于这类患者，及时的识别和治疗有助于改善预后。本文报告1 例19 岁的青年男性，在近半年时间内大剂量吸食“笑气”，出现幻听、被害妄想、关系妄想和情绪不稳。同时存在肢体无力，全身“ 手套- 袜套” 样痛觉过敏等神经症状。予大剂量维生素B12 补充为主的治疗后，患者精神症状改善，神经损害好转，但下肢远端未完全恢复。治疗上，应遵循成瘾综合干预措施，除了及时修复神经损害外，还应增强患者治疗动机，针对复吸诱发因素加强干预，这对患者长期预后及回归社会非常有益。.
Keywords: mental disorders; neurologic impairment; nitrous oxide; vitamin B12.