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Objective: To review the signs and symptoms of Wernicke encephalopathy (WE) after bariatric surgery based on 2 case reports and a literature data analysis. Methods: We present two case reports of WE. In these patients, thiamine deficiency developed due to bariatric gastric surgery, which was performed to treat class III obesity, formerly known as morbid obesity. The patients underwent comprehensive physical and neurological examinations; clinical, laboratory, and instrumental data were collected from medical records and analyzed. The researchers also performed a computerized search using the keywords "Wernicke encephalopathy after bariatric surgery" to find relevant publications in the PubMed/Medline, Scopus, and Web of Science databases. Results: The presented acute neurological condition related to vitamin B1 deficiency in two patients after undergoing a weight loss surgery, specifically a mini-gastric bypass. The clinical picture in one patient was dominated by memory impairment, ataxic, and polyneuritic syndrome, while in the other, it was only polyneuritic syndrome. Conclusion: The initial symptoms of WE are often overlooked, leading to the progression of the disease with the development of severe neurological deficits. To prevent the progression of encephalopathy, it is necessary to begin treatment with high doses of parenteral thiamine replacement therapy as early as possible. Keywords: Obesity, bariatric surgery, Wernicke encephalopathy, thiamine, case report
Objective: To review the signs and symptoms of Wernicke encephalopathy (WE) after bariatric surgery based on 2 case reports and a literature data analysis. Methods: We present two case reports of WE. In these patients, thiamine deficiency developed due to bariatric gastric surgery, which was performed to treat class III obesity, formerly known as morbid obesity. The patients underwent comprehensive physical and neurological examinations; clinical, laboratory, and instrumental data were collected from medical records and analyzed. The researchers also performed a computerized search using the keywords "Wernicke encephalopathy after bariatric surgery" to find relevant publications in the PubMed/Medline, Scopus, and Web of Science databases. Results: The presented acute neurological condition related to vitamin B1 deficiency in two patients after undergoing a weight loss surgery, specifically a mini-gastric bypass. The clinical picture in one patient was dominated by memory impairment, ataxic, and polyneuritic syndrome, while in the other, it was only polyneuritic syndrome. Conclusion: The initial symptoms of WE are often overlooked, leading to the progression of the disease with the development of severe neurological deficits. To prevent the progression of encephalopathy, it is necessary to begin treatment with high doses of parenteral thiamine replacement therapy as early as possible. Keywords: Obesity, bariatric surgery, Wernicke encephalopathy, thiamine, case report
Introduction: Wernicke’s encephalopathy is a life-threatening disease caused by thiamine deficiency with the development of damage to brain. Objective: to analyze the etiological factors, clinical, laboratory and instrumental data, as well as clinical outcomes of Wernicke’s encephalopathy.Material and мethods: the study included 36 patients with Wernicke’s encephalopathy. the average age of patients was 54.5 ± 15.9 years, women were 52.8%, men — 47.2%.Results: the most common causes of Wernicke’s encephalopathy were long-term alcohol abuse and diseases of the gastrointestinal tract or liver. A decrease in the level of wakefulness was detected in 63.9% of patients at the onset of the disease and in 72.2% during the entire period of hospitalization. In all patients, MRI of the brain revealed symmetrical areas of increased signal in the T2 FLAIR and DWI modes in the medial parts of both thalami, and in some cases also in the area of the quadrigeminal plate and/or periaqueductal space of the midbrain.Conclusion. Assessment of blood thiamine levels is not mandatory before starting therapy; thiamine administration should be started without laboratory confirmation of deficiency. Preventive administration of thiamine at a dose of 1000 mg per day is justified for any clinical suspicion of Wernicke’s encephalopathy.
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