Wernicke encephalopathy is a syndrome that affects the nervous system and brain.
This syndrome can lead to confusion and the inability to co-ordinate movement, and is caused by a lack of vitamin B1, or thiamine.
Drs Sonal Singh and Abhay Kumar from North Carolina found that frequent vomiting after surgery can lead to the syndrome.
The team performed a systematic review of MEDLINE, Embase, Ovid, Science Citation Index, and Google Scholar.
The team searched for case reports, case series, or cohort studies of Wernicke encephalopathy after bariatric surgery.
The researchers identified 32 cases of Wernicke encephalopathy after obesity surgery.
Of these, 27 were women.
Most patients had vomiting as a risk factor.
|21 patients presented with the triad of Wernicke encephalopathy|
The team observed that 21 patients presented with the triad of Wernicke encephalopathy, which included confusion, ataxia, and nystagmus.
Optic neuropathy, papilledema, deafness, seizures, asterixis, weakness, and sensory and motor neuropathy were also reported.
The team state that it is not clear if the condition is more common in women, or if there were more cases in women as 75% of obesity surgery patients are female.
The team found the syndrome to occur within one to three months of weight loss surgery, such as gastric bypass surgery, although one case occurred 18 months after surgery.
The researchers urged those who had undergone weight loss surgery to take their prescribed vitamin supplements.
Patients should be alert for symptoms such as vomiting, confusion, visual changes and lack of co-ordination.
The team encouraged people who have had weight loss surgery and start experiencing any of these symptoms to see a doctor right away.
Dr Colin Waine, of the National Obesity Forum urged against avoidance of weight loss surgery, for those most in need.
Dr Waine commented, “The results of weight loss surgery can be very good.”
“Some people are so at risk that they are going to die from other causes without surgery.”
“The risk of encephalopathy is probably much less than the risk they are facing from obesity.”
“We clearly need to note this report, and must be aware of it, but I don't think it should lead to a knee-jerk rejection.”
Dr Singh and colleague conclude, “Wernicke encephalopathy after bariatric surgery usually occurs between 4 and 12 weeks postoperatively, especially in young women with vomiting.”
“If treated promptly, the outlook is usually good.”
“For treatment, patients are given vitamin B1 through an IV or injection.”
"We found that of the 32 people in the study, 13 made a full recovery, though others continued to have problems such as memory loss."
“More studies are needed to determine how often the syndrome occurs after weight loss surgery.”