Wernicke encephalopathy after bariatric surgery: a systematic review

Area of Science:

• Neurology
• Gastroenterology
• Bariatric Surgery

Background:

• Bariatric surgery is increasingly common, with over 205,000 procedures in the US in 2007.
• These procedures carry a risk of severe nutritional complications.
• Wernicke encephalopathy (WE) is a potential neurological complication.

Purpose of the Study:

• To review the clinical essentials of Wernicke encephalopathy (WE) following bariatric surgery.
• To highlight the increasing incidence and risk factors associated with WE post-bariatric procedures.

Main Methods:

• Literature searches were conducted in Medline and Embase.
• Inclusion criteria involved diagnosed WE after bariatric surgery with specific clinical signs.
• 84 cases of WE post-bariatric surgery were analyzed.

Main Results:

• Gastric bypass or restrictive procedures were most common (95%).
• WE typically occurred within 6 months of surgery (94%), with frequent vomiting as a major risk factor (90%).
• 49% experienced incomplete recovery, with memory deficits and gait issues as common sequelae.

Conclusions:

• The incidence of WE after bariatric surgery is higher than previously recognized.
• Increased awareness of predisposing factors and symptoms is essential for prevention and management.
• Healthcare providers and patients must be informed about the risks and early signs of WE.