Wernicke's encephalopathy

Thiamine deficiency

Weight loss

Ataxia

Surgery

Hyperemesis gravidarum

Vomiting

Psychiatry

Thiamine

Pediatrics

Sleeve gastrectomy

Encephalopathy

Gastric bypass

Internal medicine

Medicine

Obesity

General surgery

Gastric bypass surgery

Wernicke Encephalopathy

Obesity Surgery

Half a million bariatric procedures are performed annually worldwide. Our aim was to review the signs and symptoms of Wernicke's encephalopathy (WE) after bariatric surgery. We included 118 WE cases. Descriptions involved gastric bypass (52%), but also newer procedures like the gastric sleeve. Bariatric WE patients were younger (median = 33 years) than those in a recent meta-analysis of medical procedures (mean = 39.5 years), and often presented with vomiting (87.3%), ataxia (84.7%), altered mental status (76.3%), and eye movement disorder (73.7%). Younger age seemed to protect against mental alterations and higher BMI against eye movement disorders. The WE treatment was often insufficient, specifically ignoring low parenteral thiamine levels (77.2%). In case of suspicion, thiamine levels should be tested and treated adequately with parenteral thiamine supplementation.

Preventing Wernicke Encephalopathy After Bariatric Surgery