The prevalence of obesity is increasing worldwide, and therefore, bariatric surgery is being routinely performed. Bariatric surgery may be associated with complications in the post-operative period. Here I present one such complication. A 25-year old man presented with visual disturbances (diplopia, blurred vision), memory disturbances and imbalance while walking of 3 days duration. He underwent bariatric surgery about three weeks ago. He was on inadequate diet since then. MRI brain showed hyperintense lesions in bilateral periaqueductal grey matter and mamillary bodies. These findings were classical of Wernicke’s encephalopathy. He was treated with thiamine injections, followed by thiamine tablets, which resulted in significant recovery.
Wernicke’s encephalopathy most commonly occurs in the setting of chronic alcoholism. Other causes include starvation, hyperemesis gravidarum, bariatric surgery and HIV infection.