Abstract Details

Title Unfortunate Consequences of Losing Weight - A Case of Wernicke Encephalopathy and Bariatric Beriberi after Gastric Bypass Surgery

Topic Neurotoxicology

Presentation(s) P06 - (-)

Poster/Presentation
Number 209

Objective

Background BACKGROUND: In order to lose weight more and more individuals are undergoing bariatric surgery. Reduced stomach surface area and the often associated frequent vomiting may lead to significant dietary vitamin deficiencies. Wernicke encephalopathy is a syndrome caused by Vitamin B1 deficiency and is characterized by abnormalities in mentation, eye movements and gait. In addition, there is a sensory and motor axonal peripheral neuropathy associated with Vitamin B1 deficiency following bariatric surgery which is often referred to as bariatric beriberi.

Design/Methods DESIGN/METHODS: Chart and literature review.

Results RESULTS: We report a 37 year old woman who presented after gastric bypass surgery with 6-8 weeks of progressive cognitive decline, nystagmus in all directions of gaze, significant impairment of gait and paresthesias of bilateral distal lower extremities. Based on MRI findings and Electromyography, our workup revealed acute Wernicke encephalopathy and an acute predominantly axonal motor peripheral neuropathy due to low Vitamin B1 levels. Her symptoms improved but did not fully resolve with administration of Thiamine.

Conclusions CONCLUSIONS: Wernicke encephalopathy and bariatric beriberi are potentially disabling neurological complications of acute Vitamin B1 deficiency that can follow bariatric surgery. Knowledge and recognition of the typical signs and symptoms of this condition is crucial in order to lead to early initiation of the appropriate treatment in the hope of preventing long term disability.

Authors/Disclosures
Sylvia C. Kurz, MD, PhD (Yale University School of Medicine) PRESENTER	Dr. Kurz has received personal compensation in the range of $0-$499 for serving as a Consultant for Advanced Accelerator Applications.
Murad M. Talahma, MD (Ochsner Medical Center)	No disclosure on file
Hesham Masoud, MD (Department of Neurology)	Dr. Masoud has nothing to disclose.
	No disclosure on file
Stephen Wanaski, PhD (Paragon Biosciences)	Dr. Wanaski has received personal compensation for serving as an employee of Paragon Biosciences. Dr. Wanaski has or had stock in Paragon Biosciences.Dr. Wanaski has or had stock in Emalex Biosciences.
Michael W. Devereaux, MD, FAAN (Univ Hospitals of Cleveland)	Dr. Devereaux has received personal compensation for serving as an employee of DigiTrace part of Sleepmed. Dr. Devereaux has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Kevin Trangle and Associates.

��ɫ��

��ɫ��