Neurological complications following bariatric surgery

Abstract

Objective: It was to report on Brazilian cases of neurological complications from bariatric surgery. The literature on the subject is scarce. Method: Cases attended by neurologists in eight different Brazilian cities were collected and described in the present study. Results: Twenty-six cases were collected in this study. Axonal polyneuropathy was the most frequent neurological complication, but cases of central demyelination, Wernicke syndrome, optical neuritis, radiculits, meralgia paresthetica and compressive neuropathies were also identified. Twenty-one patients (80%) had partial or no recovery from the neurological signs and symptoms. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications that should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.Key words: bariatric surgery, demyelination, neuropathy, Wenicke syndrome. RESUMOObjetivo: Foi relatar casos de pacientes brasileiros com complicações neurológicas da cirurgia bariátrica. A literatura no assunto é escassa. Método: Foram reunidos e descritos casos atendidos por neurologistas em oito cidades brasileiras diferentes. Resultados: Vinte e seis casos foram coletados neste estudo. A complicação neurológica mais frequente foi a polineuropatia axonal, mas também foram identificados casos de desmielinização central, síndrome de Wernicke, neurite óptica, radiculites, meralgia parestésica e neuropatias compressivas. Vinte e um pacientes (80%) não tiveram recuperação ou tiveram apenas recuperação parcial dos sinais e sintomas neurológicos. Conclusão: A cirurgia bariátrica, procedimento cada vez mais popularizado, não está livre de potenciais complicações neurológicas as quais deveriam ser claramente expostas aos indivíduos que a ela se submetem. Embora não possa ser estabelecida uma clara relação causa-efeito entre essa cirurgia e os sinais e sintomas referidos nos casos aqui apresentados, a literatura consultada mostrou ser importante alertar o indivíduo acerca dos riscos potenciais envolvidos nesse procedimento.Palavras-Chave: cirurgia bariátrica, desmielinização, neuropatia, síndrome de Wenicke.

Postbariatric Surgery Neuropathic Pain (PBSNP): Case Report, Literature Review, and Treatment Options

“…In another study, the peroneal nerve was most susceptible for neuropathy [20]. One case of acute brachial neuropathy and acute brachial radiculitis, also known as Parsonage–Turner syndrome, has been reported [21]. Rapid weight loss postsurgery is the most commonly observed risk factor in these conditions.…”

“…We identified two high‐quality retrospective controlled cohort studies [15,16], one prospective case series [17], four retrospective case series [18–21], five high‐quality review articles [22–26], and four studies that analyzed the pharmacokinetics of neuropathic analgesics in the PBS scenario [27–30]. No randomized controlled trials, controlled trials on identification of incidence, precise pathology, and management of pain or evidence‐based protocols for therapeutic management were identified.…”

Copper Deficiency Myeloneuropathy Mimicking Subacute Combined Degeneration Following Bariatric Surgery

“…It is a potential cause for malabsorption or limited absorption surface resulting in nutritional deficiency-related neuropathies and myelopathy. Nutritional complications following BS may occur for a variety of reasons including reduced dietary intake, reduced gastric acid, inadequate intrinsic factor secretion, or lack of nutrient exposure to the duodenum [4]. Neurological complications following BS in two prior large studies are reported to occur in 5% -16% of patients according to a review of 18 surgical series reported between 1976 -2004 [5].…”

Thiamin in Clinical Practice

“…Several reviews and studies on “bariatric beriberi” and neurologic complications following bariatric surgery have been published 54 , 86 . ‐ 94 In a nonrandomized controlled study, Thaisetthawatkul et al 89 evaluated the frequency of peripheral neuropathy in post–bariatric surgery patients compared with age‐ and gender‐matched controls of obese patients undergoing cholecystectomy.…”