Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery.
Bariatric surgery is frequently indicated in the treatment of morbid obesity. Previously unreported complications have been associated to this surgery; among them, neurological complications have gained attention. We report the case of a 25-year-old man submitted to gastric surgery for treatment of morbid obesity who developed, two months after surgery, acute proximal weakness in lower limbs. The electroneuromyography revealed axonal peripheral polyneuropathy with predominant proximal involvement. After treatment with immunoglobulin and vitamin supplementation, rapid clinical and neurophysiologic recovery was observed. We describe the clinical and electroneuromyographic features of this case, stressing the difficulty of initial diagnosis, particularly in the differential diagnosis with Guillain-Barré syndrome. We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients.
Machado
Flavia Costa Nunes
FC
Department of Clinical Neurophysiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. flaviacnm@einstein.br
Valério
Berenice Cataldo Oliveira
BC
Morgulis
Roberto Naun Franco
RN
Nunes
Karlo Faria
KF
Mazzali-Verst
Sílvia
S
D000208:Acute Disease; D000328:Adult; D001369:Axons / Q000473:pathology*; D050110:Bariatric Surgery / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004576:Electromyography; D020275:Guillain-Barre Syndrome / Q000175:diagnosis; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011115:Polyneuropathies / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*