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Unusual Late-Onset Wernicke’s Encephalopathy Following Vertical Banded Gastroplasty

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Abstract

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.

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Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, c/Martín Lagos s/n, 28040, Madrid, Spain

    María Victoria Velasco, Lucio Cabrerizo & Miguel A. Rubio

  2. Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain

    Ignacio Casanova & Jesus Puerta

  3. Department of Surgery, Hospital Clínico San Carlos, Madrid, Spain

    Andrés Sanchez-Pernaute, Elia Pérez-Aguirre & Antonio Torres

Authors
  1. María Victoria Velasco
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  2. Ignacio Casanova
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  3. Andrés Sanchez-Pernaute
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  4. Elia Pérez-Aguirre
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  5. Antonio Torres
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  6. Jesus Puerta
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  7. Lucio Cabrerizo
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  8. Miguel A. Rubio
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Corresponding author

Correspondence to Miguel A. Rubio.

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Velasco, M.V., Casanova, I., Sanchez-Pernaute, A. et al. Unusual Late-Onset Wernicke’s Encephalopathy Following Vertical Banded Gastroplasty. OBES SURG 19, 937–940 (2009). https://doi.org/10.1007/s11695-009-9841-7

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  • DOI: https://doi.org/10.1007/s11695-009-9841-7

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