Wernicke’s Encephalopathy in a Bariatric Surgery Patient: A Case Report and Review of the Literature

Atat Rami and Msheik Ali

Department of Neurology, ZHUMC, Lebanon
Department of Internal Medicine, Lebanese University, Lebanon

^*Correspondance to: Msheik Ali 

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Abstract:

Wernicke’s encephalopathy is an often unrecognized disease that usually results from chronic alcoholism. Up to 50% of cases could be attributed to prolonged parenteral nutrition, malignancy, AIDS, chronic malnutrition, or gastrointestinal tract surgery. We describe a case of a patient who presented with 3 days history of blurred vision and gait disturbance. On examination, she was moderately emaciated. There were no detectable lymph nodes. Abdominal, pulmonary and cardiac examination was normal. Central nervous system examination revealed bilateral abducens nerve palsy, right-sided complete oculomotor nerve palsy, and left-sided partial oculomotor nerve palsy. She had horizontal diplopia of vision of near and far objects. The patient had an unstable gait with ataxia. CT angioscan of the brain was normal. Cerebral MRI of the brain was normal. The patient had a history of gastric sleeve surgery 3 months before presentation. Thiamin level was requested and she was given thiamin supplement with multivitamin B supplement. Her symptoms improved and subsided by the second day of treatment. It is important to consider Wernicke’s encephalopathy in patients with neurological symptoms and a history of gastric sleeve surgery.

Keywords:

Wernicke’s Encephalopathy (WE); Thiamine; Ophthalmoplegia; Mental status changes

Cite the Article:

Rami A, Ali M. Wernicke’s Encephalopathy in a Bariatric Surgery Patient: A Case Report and Review of the Literature. Clin Case Rep Int. 2022; 6: 1331.