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Bariatric surgery is a frequent treatment for obesity. Neurologic complications after surgery include encephalopathy, behavioral abnormalities, seizures, cranial nerve palsies, ataxia, plexopathy, myelopathy, polyneuropathy, mononeuropathy (carpal tunnel syndrome, meralgia paresthetica), compartment syndrome, neuropathy, and myopathy. In particular, Wernicke encephalopathy, caused by vitamin B1 deficiency, can result in permanent neurologic deficit.1,2 We report unusual clinical and imaging findings in a postgastric bypass patient with Wernicke encephalopathy.
Case report.
A 35-year-old woman underwent gastric bypass surgery for obesity. Subsequently, she reported anorexia, nausea, vomiting, and generalized fatigue, resulting in hospitalization. The patient continued to develop progressive hearing loss, psychomotor slowing, apathy, forgetfulness, ataxia, and bilateral hand paresthesias. In the 12th postoperative week, she had lost 40 lbs, was lethargic and confused, and had difficulty walking. She was awake but not attentive, speech was fluent, and comprehension was decreased. Pupils were equal and reactive to light, extraocular movements were intact, there was no nystagmus, and hearing …
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Letters: Rapid online correspondence
- Wernicke encephalopathy after bariatric surgery: Losing more than just weight
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