Education and debate

Lesson of the Week: Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity

BMJ 1996; 312 doi: 10.1136/bmj.312.7028.434 (Published 17 February 1996)
Cite this as: BMJ 1996;312:434

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  1. H Seehra, research registrara,
  2. N MacDermott, senior registrarb,
  3. R G Lascellesb, consultant,
  4. T V Taylor, readera
  1. a Department of Surgery, Manchester Royal Infirmary, Manchester M13 9WL
  2. b Department of Neurology, Manchester Royal Infirmary, Manchester M13 9WL
  1. Correspondence to: Mr Seehra.
  • Accepted 14 July 1995

Thiamine deficiency is known to lead to certain neurological sequelae including Wernicke-Korsakoff encephalopathy. Signs attributable to this condition include ataxia, ophthalmoplegia, nystagmus, and mental confusion. Recognised predisposing conditions include alcoholism, gastric carcinoma, pyloric obstruction, hyperemesis gravidarum, and prolonged intravenous feeding.1 We have recently encountered two cases of Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity. Other neurological sequelae are recognised after vertical banded gastroplasty, including Guillain-Barre syndrome, psychosis, and pseudoathetosis, but the causes of these are multifactorial.2

Nutritional

supplementation after

surgery for morbid

obesity is essential to

prevent neurological

sequelae

Case reports CASE 1

A 55 year old women weighing 171.4 kg underwent a vertical banded gastroplasty on 16 March 1992. Her medical …

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