Lesson of the Week: Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity

Abstract

Thiamine deficiency is known to lead to certain neurological sequelae including Wernicke-Korsakoff encephalopathy. Signs attributable to this condition include ataxia, ophthalmoplegia, nystagmus, and mental confusion. Recognised predisposing conditions include alcoholism, gastric carcinoma, pyloric obstruction, hyperemesis gravidarum, and prolonged intravenous feeding.1 We have recently encountered two cases of Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity. Other neurological sequelae are recognised after vertical banded gastroplasty, including Guillain-Barre syndrome, psychosis, and pseudoathetosis, but the causes of these are multifactorial.2 Nutritional supplementation after surgery for morbid obesity is essential to prevent neurological sequelae A 55 year old women weighing 171.4 kg underwent a vertical banded gastroplasty on 16 March 1992. Her medical …