title: Wernicke Encephalopathy in Adolescents After Bariatric Surgery: Case Report and Review.
abstract: Roughly 1% of all weight loss surgery is performed in adolescents. There is strong evidence demonstrating significant postsurgical weight loss, improvement in quality of life, and reduction in comorbidities such as hypertension and diabetes. Reports of postoperative complications in adolescents are few because of the small sample size in most series. Despite vitamin supplementation, nutritional deficiencies requiring hospitalization occur occasionally after Roux-en-Y gastric bypass. Wernicke encephalopathy, a triad of ophthalmoplegia, ataxia, and altered mental status, is a serious consequence of thiamine (vitamin B1) deficiency. Few cases of Wernicke encephalopathy after weight loss surgery have been reported in the literature and even fewer in the pediatric population. Here we describe a teenage girl who develops vomiting after Roux-en-Y gastric bypass and presented with nystagmus, irritability, and ataxia. The clinical presentation, diagnosis, and treatment of Wernicke encephalopathy in adolescents after bariatric surgery are discussed.
authors.affiliation: Departments of Pediatric Neurology and aarmstrong-javors@partners.org.
authors.forename: Amy
authors.initials: A
authors.lastname: Armstrong-Javors
authors.affiliation: Surgery, and.
authors.forename: Janey
authors.initials: J
authors.lastname: Pratt
authors.affiliation: Division of Pediatric Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Sigmund
authors.initials: S
authors.lastname: Kharasch
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D013832:Thiamine Deficiency / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014899:Wernicke Encephalopathy / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy