A new US study suggests that obesity surgery such as gastric bypasses can cause vitamin deficiency that leads to memory loss, confusion, co-ordination, and other neurological problems.
The study is published in the journal Neurology.
A neurological sydrome called Wernicke encephalopathy occurs mostly in patients who vomit a lot after they have had weight loss surgery (also known as bariatric surgery). It usually starts between one and three months after surgery, but in one case it was over a year later.
Wernicke encephalopathy affects the brain and nervous system and develops when there is a shortage of vitamin B1 (thiamine) in the body. The syndrome also causes vision problems such as rapid eye movements.
The research was conducted by Dr Sonal Singh of Wake Forest University School of Medicine in Winston-Salem, North Carolina, assisted by Dr Abhay Kumar of the University of Iowa.
They scanned the scientific literature for all known cases of the syndrome emerging after obesity surgery and found that 32 had been reported.
“When people who have had weight loss surgery start experiencing any of these symptoms, they need to see a doctor right away,” said Dr Singh. “If treated promptly, the outlook is usually good,” he added.
He urges doctors to consider vitamin B1 deficiency and Wernicke encephalopathy when patients develop these neurological complications after weight loss surgery.
Many of the patients who developed Wernicke encephalopathy after obesity surgery also had other neurological symptoms such as seizures, psychosis, deafness, muscle weakness and painful or numb hands or feet.
The syndrome can emerge after any of the obesity surgery procedures, including banding where the stomach is divided into two compartments, and gastric bypass where a part of the stomach is sectioned off and reattached lower down after the small intestine.
Wernicke encephalopathy is treated by giving patients vitamin B1 either intravenously or by injection. Drs Sing and Kumar found that of the 32 people, 13 made a full recovery, but most of them continued to suffer memory loss, weakness or movement coordination problems.
They suggested more studies should be done to assess how often the syndrome occurs after obesity surgery and mentioned that some doctors automatically prescribe thiamine supplements after obesity surgery but this is not across the board and national guidelines should be introduced for all doctors to do this routinely.
The study concludes that ” Wernicke encephalopathy after bariatric surgery usually occurs between 4 and 12 weeks postoperatively, especially in young women with vomiting.”
It adds that “Atypical neurologic features are common. The diagnosis is mainly clinical, because radiographic findings are normal in some patients.”
“Wernicke encephalopathy after obesity surgery: A systematic review.”
Sonal Singh and Abhay Kumar
Neurology 2007 68: 807-811.
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Written by: Catharine Paddock
Writer: Medical News Today