Wernicke Encephalopathy Owing to Vitamin Nonadherence Following Bariatric Surgery

Abstract

Introduction and Objective Wernicke encephalopathy (WE) is increasingly recognized as a complication of bariatric surgery precipitated by nonadherence to vitamin supplementation in the setting of presurgical hypovitaminosis, nausea, vomiting, gastrointestinal dysmotility, and the high cost of vitamins. Anticipation of this phenomenon allows prompt diagnosis and treatment, which can prevent serious neurologic morbidity and even death. Case Presentation We present a patient with prominent neuro-ophthalmic manifestations of Wernicke encephalopathy from medication nonadherence owing to a combination of factors: the high cost of vitamin supplements, nausea, and depression. Discussion Wernicke encephalopathy after bariatric surgery is likely to become more common as these procedures increase in frequency. Physicians should recognize the factors that lead to medication nonadherence in this context and anticipate the development of Wernicke encephalopathy, as early recognition is critical to prevent enduring neurologic deficits. Conclusion Anticipation of this phenomenon allows prompt diagnosis and treatment, which can prevent serious neurologic morbidity and even death.