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Wernicke Encephalopathy After Bariatric Surgery: a Literature Review

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Abstract

Wernicke encephalopathy (WE) is an acute neurological disorder classically characterized by ataxia, ophthalmoplegia, and altered mental status. This is caused by thiamine deficiency and is usually seen in malnourished populations. However, with the advent and rise of bariatric surgery in the last 50 years, WE has become an increasingly recognized and potentially deadly complication. Here, we review the populations at risk, clinical presentation, and the incidence of WE in the bariatric surgery population from 1985 to 2023. While the predominant procedure shifts throughout the years, the overall incidence of WE per 100,000 cases for the following procedures are sleeve gastrectomy (1.06), gastric band (1.16), RYGB (4.29), and biliopancreatic diversion with duodenal switch (8.92). Thus, early intervention and post-operative supplementation is recommended to prevent WE.

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Authors and Affiliations

  1. Department of Surgery, Mount Sinai Health System, New York, NY, 10029, USA

    Allen T. Yu, Aliza Gross, Koji Park & Eugenius J. Harvey

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Correspondence to Allen T. Yu.

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Key Points

• Eighteen percent already have thiamine deficiency, and surgery increases risk for developing WE.

• WE should be on the differential in patients with neurologic symptoms or vomiting.

• Post-operative supplementation of thiamine is recommended to prevent WE development.

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Yu, A.T., Gross, A., Park, K. et al. Wernicke Encephalopathy After Bariatric Surgery: a Literature Review. OBES SURG 33, 3621–3627 (2023). https://doi.org/10.1007/s11695-023-06840-8

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