Nitrous oxide (N2O) recreational use is increasing across Germany - a survey of the German neurological society among practicing neurologists

This study provides evidence of widespread N₂O abuse in Germany, with hotspots in Berlin and Frankfurt/Main, and a concerning rise in rural areas. While myelopathy is well recognized among neurologists, other clinical manifestations are underreported. Improved communication, along with standardized diagnostics and treatment protocols, is urgently needed to address the heterogenous awareness of symptomatology, diagnostic sensitivity and specificity, and therapeutic strategies.