Vertigo Research Today is a free monthly online journal that collates and summarizes the latest research about Vertigo, including details on causes, symptoms, treatment, dizziness.

Very early onset of Wernicke's encephalopathy after gastric bypass.

Al-Fahad T, Ismael A, Soliman MO, Khoursheed M

Department of Medicine, Mubarak Al-Kabeer Hospital, Qadisia 35856, Kuwait. dralfahad@yahoo.com

Postoperative complications resulting from bariatric surgery can lead to severe vitamin-deficiency states, such as Wernicke's encephalopathy (WE). We present a 29-year-old woman with BMI 41.7 with no history of alcoholism who developed acute WE after a gastric bypass for morbid obesity. After persistent vomiting for 2 weeks postoperatively, symptoms began with headache, vertigo, diplopia, nystagmus, tingling and weakness in both upper and lower extremities, urinary incontinence, and memory loss to recent events. All investigations, including upper GI endoscopy, Gastrografin meal and even MRI, were normal. A dramatic improvement occurred in 24 hrs after starting 100 mg thiamine infusion daily. We recommend that patients undergoing bariatric surgery should be started on thiamine supplementation once oral intake begins, because this case showed that postoperative acute WE can develop before 6 weeks, unlike other reports.

Published 11 May 2006 in Obes Surg, 16(5): 671-2.
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