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Neuropathy and Nitrous Oxide Exposure

John F. Kreul, MD
JAMA. 1981;245(14):1411. doi:10.1001/jama.1981.03310390019009.
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To the Editor.—  Michael A. Nevins, MD (1980;244:2264), recently described two patients who experienced peripheral neuropathy after chronic nitrous oxide abuse. His report adds further emphasis to recent Food and Drug Administration warnings concerning the short-term and long-term hazards of nitrous oxide abuse.1 Frequently, medical and dental students as well as health professionals who have easy access to the drug are involved with its abuse.2 However, even among nonabusers, a potential risk is present. As Nevins pointed out, "occupational long-term low-level exposure [has been] implicated" in some dentists with myeloneuropathy. In addition to such case reports, Cohen et al3 in an extensive survey showed that dentists and chairside assistants who employed nitrous oxide had a 1.8-fold to 4.4-fold increase in nonspecific neurological disease (tingling, numbness, and muscle weakness) as compared with colleagues who were not chronically exposed to subanesthetic levels of nitrous oxide. While such epidemiologic surveys


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