Neurologic complications of gastric bypass surgery for morbid obesity

Juhasz-Pocsine, Katalin; Rudnicki, Stacy A.; Archer, Robert L.; Harik, Sami I.

doi:10.1212/01.wnl.0000262768.40174.33

Cited by 233 publications

(183 citation statements)

References 52 publications

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“…Myelopathy due to copper deficiency can mimic vitamin B 12 deficiency [10]. Symptoms can take up to a decade to appear after the initial surgery [11]. Both zinc and copper are absorbed in the stomach and proximal duodenum.…”

Section: Discussionmentioning

confidence: 99%

Copper deficiency, a new triad: anemia, leucopenia, and myeloneuropathy

Wazir

Ghobrial

2017

Journal of Community Hospital Internal Medicine Perspectives

101

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Clinical copper deficiency is now more frequently recognized. Hematologically, it can present as anemia (microcytic, normocytic, or macrocytic) and neutropenia. Thrombocytopenia is relatively rare. Neurologically, it can manifest as myelopathy and peripheral neuropathy simulating subacute combined degeneration. Bone marrow findings can mimic myelodysplasia resulting in occasional inappropriate referral for bone marrow transplantation. Other conditions with similar presentations include infections, drug toxicity, autoimmunity, B12 deficiency, folate deficiency, myelodysplastic syndrome, aplastic anemia, and lymphoma with bone marrow involvement. Hematological, but not neurological, manifestations respond promptly to copper replacement, making early diagnosis essential for good outcome. Common risk factors for copper deficiency are foregut surgery, dietary deficiency, enteropathies with malabsorption, and prolonged intravenous nutrition (total parenteral nutrition). We present a unique case of copper deficiency, with no apparent known risk factors.

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Section: Discussionmentioning

confidence: 99%

Copper deficiency, a new triad: anemia, leucopenia, and myeloneuropathy

Wazir

Ghobrial

2017

Journal of Community Hospital Internal Medicine Perspectives

101

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“…In vitamin B12 deficiency, cerebral symptoms, such as mental slowing, depression, confusion, delusions and hallucinations are quite common, and occasionally patients present with only cognitive or psychiatric symptoms [8,9]. Our patient lost his conscious acutely and regained after a day.…”

Section: Discussionmentioning

confidence: 92%

Temporary confusion depending on the usage of naratriptan

et al. 2007

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“…29 Almost any region of the nervous system can be affected. 27,30 These complications can be early or delayed and can occur months to several years after surgery. A number of neurological complications including encephalopathy, psychiatric disorders, behavioral changes, ataxia, myelopathy, optic neuropathy, plexopathy, peripheral polyneuropathy, mononeuropathy, myopathy, myotonia, and compartment syndrome have been described.…”

Section: Neurologicalmentioning

confidence: 99%

“…30,32 The myelopathy is mostly attributed to vitamin B12 deficiency after gastric bypass surgery; however, copper deficiency is now another well-established cause of myelopathy. 30,70 Optic neuropathy can be seen along with myeloneuropathy in copper deficiency. Folate deficiency is also a potential contributor and the clinical features are indistinguishable from vitamin B12 deficiency.…”

Section: Myelopathy/myeloneuropathymentioning

confidence: 99%

An overview of complications affecting the Central Nervous System following bariatric surgery

Zafar

Khatri

2018

NSJ

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Bariatric surgery has been considered as an effective treatment for morbid obesity. Apart from procedures related complications, a broad spectrum of neurological disorders affecting any part of neuraxis has been reported following BS. Central nervous system complications, although less common than peripheral nervous system complications, carry significant morbidity and potential mortality. Encephalopathy, behavioral and psychiatric disorders, myelopathy and optic neuropathy are the most frequently reported CNS complications. Early detection and prompt management may improve or completely reverse these neurological complications. It is essential that the treating physicians must be aware of their clinical manifestations and management, so early diagnosis and treatment can prevent patients from suffering significant neurological deficits and even death. This review discusses the clinical manifestations of these complications in detail which will help concerned physician in earlier recognition and hence prevent the delay in specific treatment.

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Neurologic complications of gastric bypass surgery for morbid obesity

Abstract: A wide spectrum of serious neurologic conditions may follow bariatric surgery. These complications may occur acutely or decades later.

Cited by 233 publications

References 52 publications

Copper deficiency, a new triad: anemia, leucopenia, and myeloneuropathy

Copper deficiency, a new triad: anemia, leucopenia, and myeloneuropathy

Temporary confusion depending on the usage of naratriptan

An overview of complications affecting the Central Nervous System following bariatric surgery

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