RESEARCH - Obesity surgery can lead to memory loss and movement problems

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Article Date: 13 Mar 2007 - 13:00 PDT

Obesity Surgery Can Lead To Memory Loss And Movement Problems

A new US study suggests that obesity surgery such as gastric bypasses can

cause vitamin deficiency that leads to memory loss, confusion,

co-ordination, and other neurological problems.

The study is published in the journal Neurology.

A neurological syndrome called Wernicke encephalopathy occurs mostly in

patients who vomit a lot after they have had weight loss surgery (also known

as bariatric surgery). It usually starts between one and three months after

surgery, but in one case it was over a year later.

Wernicke encephalopathy affects the brain and nervous system and develops

when there is a shortage of vitamin B1 (thiamine) in the body. The syndrome

also causes vision problems such as rapid eye movements.

The research was conducted by Dr Sonal Singh of Wake Forest University

School of Medicine in Winston-Salem, North Carolina, assisted by Dr Abhay

Kumar of the University of Iowa.

They scanned the scientific literature for all known cases of the syndrome

emerging after obesity surgery and found that 32 had been reported.

" When people who have had weight loss surgery start experiencing any of

these symptoms, they need to see a doctor right away, " said Dr Singh. " If

treated promptly, the outlook is usually good, " he added.

He urges doctors to consider vitamin B1 deficiency and Wernicke

encephalopathy when patients develop these neurological complications after

weight loss surgery.

Many of the patients who developed Wernicke encephalopathy after obesity

surgery also had other neurological symptoms such as seizures, psychosis,

deafness, muscle weakness and painful or numb hands or feet.

The syndrome can emerge after any of the obesity surgery procedures,

including banding where the stomach is divided into two compartments, and

gastric bypass where a part of the stomach is sectioned off and reattached

lower down after the small intestine.

Wernicke encephalopathy is treated by giving patients vitamin B1 either

intravenously or by injection. Drs Sing and Kumar found that of the 32

people, 13 made a full recovery, but most of them continued to suffer memory

loss, weakness or movement coordination problems.

They suggested more studies should be done to assess how often the syndrome

occurs after obesity surgery and mentioned that some doctors automatically

prescribe thiamine supplements after obesity surgery but this is not across

the board and national guidelines should be introduced for all doctors to do

this routinely.

The study concludes that " Wernicke encephalopathy after bariatric surgery

usually occurs between 4 and 12 weeks postoperatively, especially in young

women with vomiting. "

It adds that " Atypical neurologic features are common. The diagnosis is

mainly clinical, because radiographic findings are normal in some patients. "

" Wernicke encephalopathy after obesity surgery: A systematic review. "

Sonal Singh and Abhay Kumar

Neurology 2007 68: 807-811.

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