Wernicke’s Encephalopathy Following Bariatric Surgery

MRI Brain showing hyperintense lesions in bilateral mamillary bodies and periaqueductal gray matter

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.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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