Weight loss surgery, such as gastric bypass surgery,
can lead to a vitamin deficiency that can cause memory
loss and confusion, inability to coordinate movement,
and other problems, according to a study published in
the March 13, 2007, issue of Neurology®, the scientific
journal of the American Academy of Neurology.
The syndrome, called Wernicke encephalopathy, affects
the brain and nervous system when the body doesn’t get
enough vitamin B1, or thiamine. It can also cause vision
problems, such as rapid eye movements.
The study found that the syndrome occurs most often
in people who have frequent vomiting after the surgery.
It usually occurs within one to three months after the
surgery, although one case occurred 18 months after
surgery.
The study reviewed the scientific literature for all
reported cases of the syndrome occurring after obesity
surgery. A total of 32 cases had been reported. Many
of the people also had neurological symptoms that are
not typical of Wernicke encephalopathy, such as seizures,
deafness, psychosis, muscle weakness, and pain or numbness
in the feet or hands.
"When people who have had weight loss surgery start
experiencing any of these symptoms, they need to see
a doctor right away," said study author Sonal Singh,
MD, of Wake Forest University School of Medicine in
Winston-Salem, North Carolina. "Doctors should consider
vitamin B1 deficiency and Wernicke encephalopathy when
they see patients with these types of neurological complications
after weight loss surgery. If treated promptly, the
outlook is usually good."
For treatment, patients are given vitamin B1 through
an IV or injection. Of the 32 people, 13 made a full
recovery. Many people continued to have problems, such
as memory problems, weakness, or difficulty coordinating
movement.
Singh said more studies are needed to determine how
often the syndrome occurs after weight loss surgery.
He said some doctors prescribe thiamine supplementation
for their patients after weight loss surgery, but recommends
that national standards be set for all doctors to follow.
