An Autopsy Case of Misdiagnosed Wernicke’s Syndrome after Intragastric Balloon Therapy

Abstract

Intragastric balloon (IGB) therapy is a widely used technique to counter obesity, and it is known to be safe and effective. Although there can be a high rate of side effects following IGB therapy, most are self-healing and they are mainly accommodative in nature. Few cases of Wernicke's syndrome under IGB therapy have been described in the literature, and to the best of our knowledge, none have been fatal. We present here a case of a 51-year-old woman who underwent IGB therapy over 8 months. Late diagnosed Wernicke's syndrome that first appeared as lower limb neuropathy progressively immobilized the patient, until she required bed rest. Finally, a major complication of pneumonia caused her death. Wernicke's syndrome has been mainly related to bariatric surgery techniques, but it must also be linked to IGB therapy (and also to other restrictive weight-loss interventions). As the use of IGB therapy spreads, the literature must alert physicians to this complication. Wernicke's syndrome is a severe but reversible condition when diagnosed and treated early.

Wernicke’s Encephalopathy: An Overlooked Cause

“…MRI findings along with clinical signs and symptoms provide reliable approach to diagnose WE [15]. report came back [6] which revealed mammillary body necrosis. Prognosis of WE depends on prompt diagnosis and management [7].…”

“…Chronic alcoholism is the most commonly known cause [1,2]. In non-alcoholic population, history of total parenteral nutrition, eating disorders, multiple bowel surgeries, chemotherapy and conditions such as hyperemesis gravidarum are risk factors for WE [1,[3][4][5][6][7][8][9][10][11]. Despite several reports, diagnosis of WE is commonly delayed or overlooked [3].…”