title: Rare Neurological Complications After Sleeve Gastrectomy.
abstract: Bariatric surgery is considered to be the most effective treatment of morbid obesity and improvement of obesity-related comorbidities, such as type II diabetes. However, both peripheral and central neurological complications can occur after bariatric surgery. Such complications tend to occur more frequently after bypass surgery than after sleeve gastrectomy (SG). The objective of this study was to identify the patients that presented post-operative neurological complications after undergoing SG and describe the incidence, presentation, and management of these complications.
  
  
  
  This was a retrospective study of 592 cases of SG performed between 2009 and 2014 with a special focus on patients who presented neurological complications.
  
  
  
  Of the 592 SG cases, only seven (1.18 %) patients presented neurological complications. All patients had uneventful post-operative course, but all reported feeding difficulties, accompanied by severe dysphagia, and rapid weight loss, with a mean weight loss of 35 kg (30-40 kg) 3 months after SG. All patients were readmitted owing to neurological symptoms that included paresthesia, abolition of deep tendon reflexes of the lower limbs, muscle pain, and motor and sensitive deficits in some cases. There were two cases of Wernicke's encephalopathy. All patients were treated for neuropathy secondary to vitamin B1 deficiency and had a significant improvement and/or resolution of their symptoms.
  
  
  
  Neurological complications after SG are rare and are often preceded by gastrointestinal symptoms, rapid weight loss, and lack of post-operative vitamin supplementation. Re-hospitalization and multidisciplinary team management are crucial to establish the diagnosis and initiate treatment.
authors.affiliation: Assistance Publique Hôpitaux de Paris (AP-HP); Department of Digestive and Metabolic Surgery, Avicenne Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, 125 rue de Stalingrad, 93000, Bobigny, France. malektabbara@gmail.com.
authors.forename: Malek
authors.initials: M
authors.lastname: Tabbara
authors.affiliation: Assistance Publique Hôpitaux de Paris (AP-HP); Department of Digestive and Metabolic Surgery, Avicenne Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, 125 rue de Stalingrad, 93000, Bobigny, France.
authors.forename: Sergio
authors.initials: S
authors.lastname: Carandina
authors.affiliation: Assistance Publique Hôpitaux de Paris (AP-HP); Department of Digestive and Metabolic Surgery, Avicenne Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, 125 rue de Stalingrad, 93000, Bobigny, France.
authors.forename: Manuela
authors.initials: M
authors.lastname: Bossi
authors.affiliation: Assistance Publique Hôpitaux de Paris (AP-HP); Department of Digestive and Metabolic Surgery, Avicenne Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, 125 rue de Stalingrad, 93000, Bobigny, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Polliand
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver transplantation, Pitié-Salpêtrière University Hospital, Pierre and Marie Curie University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Genser
authors.affiliation: Assistance Publique Hôpitaux de Paris (AP-HP); Department of Digestive and Metabolic Surgery, Avicenne Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, 125 rue de Stalingrad, 93000, Bobigny, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Barrat
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011184:Postoperative Period; D012189:Retrospective Studies; D013832:Thiamine Deficiency / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D014899:Wernicke Encephalopathy / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
keywords: Peripheral neuropathy; Sleeve gastrectomy; Vitamin B1 deficiency; Wernicke’s encephalopathy