Unusual late-onset Wernicke's encephalopathy following vertical banded gastroplasty.
Wernicke's encephalopathy (WE) related to bariatric surgery is the consequence of thiamine depletion occurring usually after restrictive surgical procedures with gastric outlet impairment causing frequent vomiting. We present a 35-year-old man with body mass index of 47.2 who developed a WE 7 years after a vertical banded gastroplasty. Late stenosis of the outlet due to gastric band inclusion was the precipitating mechanism. Poor compliance of dietary pattern and vitamin supplementation along with episodic vomiting both contributed to progressive symptoms of instable gait and mental changes. Magnetic resonance imaging confirmed the diagnosis of WE by showing hyperintense T2 signals at the mammillary bodies. Recovery of symptoms was possible after early thiamine therapy. Unusual late-onset symptoms and contributing factors to WE are discussed.
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, 28040, Madrid, Spain.
María Victoria
MV
Velasco
Ignacio
I
Casanova
Andrés
A
Sanchez-Pernaute
Elia
E
Pérez-Aguirre
Antonio
A
Torres
Jesus
J
Puerta
Lucio
L
Cabrerizo
Miguel A
MA
Rubio
D000328:Adult; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D008297:Male; D014899:Wernicke Encephalopathy / Q000209:etiology*