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Polyneuropathy after gastric bypass

Suriya Punchai, Zubaidah Nor Hanipah, Katherine M Meister, Philip R Schauer, Stacy A Brethauer, Ali Aminian
INTRODUCTION: The aim of this study was to assess the incidence, clinical presentation, and outcomes of neurologic disorders secondary to vitamin B deficiencies following bariatric surgery. METHODS: Patients at a single academic institution who underwent bariatric surgery and developed neurologic complications secondary to low levels of vitamins B1, B2, B6, and B12 between the years 2004 and 2015 were studied. RESULTS: In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies...
August 2017: Obesity Surgery
Linda O Arnadottir, Svanur Sigurbjornsson, Tomas Gudbjartsson
Beriberi is primarily related to malnutrition, but also known as a complication following abdominal surgical procedures. A 41 year old woman, who underwent gastric bypass surgery 10 years earlier, presented at the emergency department of Landspitali with general weakness and paresthesia. Physical examination revealed muscle atrophy and attenuated deep tendon reflexes in her lower limbs; presenting as polyneuropathy due to beriberi. The diagnosis was confirmed with serum thiamine levels measuring well below reference levels...
November 2016: Læknablađiđ
W Willaert, T Henckens, D Van De Putte, K Van Renterghem, W Ceelen, P Pattyn, Y Van Nieuwenhove
BACKGROUND: Malabsorptive surgery (MAS) can cause huge weight loss but is also known for its serious side effects. We investigated whether conversion surgery is an effective treatment for MAS-induced complications. METHODS: We searched our hospital database for patients who underwent conversion surgery after MAS. Any complication was recorded till time of conversion. The conversion techniques and their effect on the course of the patients were analyzed and compared to the situation after MAS...
July 2012: Acta Chirurgica Belgica
Kanayochukwu J Aluka, Patricia L Turner, Terrence M Fullum
BACKGROUND: Postbariatric surgery poly-neuropathies (BSP) are infrequent events. However, with the number of gastric bypasses performed each year increasing, the incidence of BSP is expected to increase as well. The long-term sequelae of BSP worsen with delays in diagnoses. Therefore, early evaluation, recognition, and treatment are important in minimizing morbidity and mortality. METHODS: We present the case report of a patient who developed a poly-neuropathy after a laparoscopic Roux-en-Y gastric bypass...
April 2009: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Miriam Seligman Menezes, Kelly O Harada, Glauco Alvarez
BACKGROUND AND OBJECTIVES: The number of patients undergoing bariatric surgery increases every year and the frequency of complications associated with this procedure has been increasing. The main complications reported are nutritional, metabolic, neurological, and psychological/psychiatric. Among the neurological complications, peripheral neuropathies are important due to their high incidence. The objective of this report was to stress the importance of this type of complication, in which the initial manifestation might be neuropathic pain followed or accompanied by motor involvement, and whose prognosis depends on early diagnosis and treatment...
May 2008: Revista Brasileira de Anestesiologia
M Pigeyre, D Seguy, L Arnalsteen, F Pattou, M Romon
The laparoscopic Roux-en-Y gastric bypass (LRYGBP) is increasingly popular for the treatment of morbid obesity, although its postsurgical complications are often underestimated. We report the case of a 22-year-old morbidly obese woman who underwent a LRYGBP, which was rapidly complicated by portal venous thrombosis and severe neurological complications due to vitamin deficiencies. She presented rapid body weight loss with optic and peripheral neuropathy. Clinical chemistry results showed low transthyretin and micronutrient levels...
September 2008: Obesity Surgery
Katalin Juhasz-Pocsine, Stacy A Rudnicki, Robert L Archer, Sami I Harik
BACKGROUND: The number of bariatric procedures is rapidly growing as the prevalence of obesity in the USA is increasing. Such procedures are not without complications, and those affecting the nervous system are often disabling and irreversible. We now describe our experience with these complications and review the pertinent literature. METHODS: We describe 26 patients with major neurologic conditions that seemed causally related to bariatric surgery encountered in the neurology service of a tertiary referral university medical center over a decade...
May 22, 2007: Neurology
Melissa Teitleman, David A Katzka
No abstract text is available yet for this article.
2005: MedGenMed: Medscape General Medicine
John D Angstadt, Richard A Bodziner
The neurologic form of beriberi has been described in multiple case reports following bariatric surgery for morbid obesity. Thiamine deficiency occurs due to marked emesis and/or altered absorption secondary to the reconfiguration of the gastrointestinal tract to achieve the malabsorption needed to achieve weight loss. This case report illustrates the typical presentation of a patient after gastric bypass, and highlights the symptoms that bariatric surgeons must detect and reviews the treatment.
June 2005: Obesity Surgery
Boyd M Koffman, L John Greenfield, Imran I Ali, Noor A Pirzada
Bariatric surgical procedures are increasingly common. In this review, we characterize the neurologic complications of such procedures, including their mechanisms, frequency, and prognosis. Literature review yielded 50 case reports of 96 patients with neurologic symptoms after bariatric procedures. The most common presentations were peripheral neuropathy in 60 (62%) and encephalopathy in 30 (31%). Among the 60 patients with peripheral neuropathy, 40 (67%) had a polyneuropathy and 18 (30%) had mononeuropathies, which included 17 (94%) with meralgia paresthetica and 1 with foot drop...
February 2006: Muscle & Nerve
John Y Choi, Terry K Scarborough
Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been an available operation for weight loss for the past decade, and bariatric surgery is increasing in the United States. Careful patient screening and follow-up have been the cornerstone for success against the complexities of morbid obesity. Neurologic complications have occurred, such as polyneuropathy and Wernicke-Korsakoff syndrome. We report an 18-year-old female with morbid obesity, steatohepatitis, tobacco, recreational drug, and oral contraceptive use who at 4 months after LRYGBP experienced a generalized seizure and stroke...
June 2004: Obesity Surgery
Craig G Chang, Beverley Adams-Huet, David A Provost
BACKGROUND: A variety of neurologic complications have been reported after weight loss surgery. Recently, a new term was introduced to describe cases of postoperative polyneuropathy - acute post-gastric reduction surgery (APGARS) neuropathy, a polynutritional, multisystem disorder characterized by protracted postoperative vomiting, hyporeflexia, and muscular weakness. The incidence, associations, and prognosis of this disorder have not been precisely defined. METHODS: A questionnaire about features of APGARS was mailed to all members of the ASBS...
February 2004: Obesity Surgery
Craig G Chang, Thomas S Helling, Whitney E Black, Marilyn M Rymer
Two patients underwent gastric bypasses and had uneventful hospital courses. In the early postoperative periods, both developed severe, protracted vomiting, weakness, and hyporeflexia. After thorough laboratory and clinical evaluations by neurologists, the patients were diagnosed with Guillain-Barré syndrome, although there were many atypical features. The clinical presentations of these patients are very similar to case reports of nutritional polyneuropathy associated with gastric partitioning. This paper addresses the difficulties of differentiating these two diagnoses...
August 2002: Obesity Surgery
Luiz Claudio Lopes Chaves, Joel Faintuch, Salomão Kahwage, Francisco de Assis Alencar
BACKGROUND: Wernicke-Korsakoff syndrome and peripheral neuropathy are very uncommon in bariatric surgical practice. The literature indicates that these complications tend to strike patients receiving unbalanced diets or undergoing rapid weight-loss. METHODS: In a retrospective analysis of the initial experience of a bariatric team in the city of Belem, Pará, in northern Brazil, 5 cases were diagnosed in the first year, 4 of them following gastric bypass and the last one after therapy with an intragastric balloon...
June 2002: Obesity Surgery
H J Sugerman
Severe obesity is associated with multiple comorbidities and is refractory to dietary management with or without behavioral or drug therapies. There are a number of surgical procedures for the treatment of morbid obesity, including purely gastric restrictive, a combination of malabsorption and gastric restriction or primary malabsorption. The purely gastric restrictive procedures, including vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding, do not provide adequate weight loss...
July 2001: Journal of the Association for Academic Minority Physicians
O Maryniak
Severe weakness in the limbs developed in a young woman 3 1/2 months after successful gastric bypass surgery for morbid obesity. Electromyography confirmed the clinical impression of generalized axonal polyneuropathy. Vitamin B replacement therapy was started. The gastric bypass was not reversed, and the patient continued to lose weight while undergoing rehabilitation. After 10 months she had almost fully recovered. Her total weight loss was 76 kg. Neuropathy is an uncommon but serious complication of semistarvation that should be preventable by routine administration of vitamin B complex...
July 15, 1984: Canadian Medical Association Journal
C Wadström, L Backman
A 20-year-old woman was admitted to hospital with acute, severe neurologic symptoms 16 weeks after gastric banding for obesity. Her postoperative weight loss was 52 kg. Before admission she had protracted periods of vomiting with; hypokalemia. The etiology of the neurologic findings remains unclear. She responded slowly to adequate nutrition and recovered within 2 years.
February 1989: Acta Chirurgica Scandinavica
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