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Rapid onset of Wernicke’s syndrome after gastric balloon positioning

European Journal of Clinical Nutrition volume 66, page 971 (2012)Cite this article

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Although well recognized after malabsorptive weight loss surgery,1 little is known about the impact of micronutrient deficiency in subjects undergoing restrictive weight loss interventions.2 We report a case of a 40-year-old super-obese woman (body mass index (BMI): 64 kg/m2) developing Wernicke's encephalopathy (WE) following Bioenterics intragastric balloon (BIB) positioning (performed as a preliminary step towards subsequent gastric bypass procedure).

At 1 day after BIB placement, she presented persisting vomiting. In the following 9 days, the patient continued vomiting and presented psychomotor agitation, diplopia, nystagmus, visual hallucinations, delutions and confabulations. Neurological examinations showed severe speech disturbance, gait impossibility for balance disturbance, mild strength decrease and severe decrease of osteotendinous reflexes of the four limbs. Bilateral Babinski’s sign was present. Clinical signs and reduced thiamine (B1) concentrations (0.1 mcg/100 ml, normal value 0.5–1.3 mcg/100 ml), allowed for a WE diagnosis.

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References

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Authors and Affiliations

  1. Department of Surgery, Orthopedic, Traumatology and Emergency, University of Naples “Federico II”, Naples, Italy

    M Milone, V Scarano, M N D Di Minno, R Lupoli, F Milone & M Musella

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  1. M Milone
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  2. V Scarano
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  3. M N D Di Minno
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  4. R Lupoli
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  5. F Milone
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  6. M Musella
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Correspondence to M Milone.

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Milone, M., Scarano, V., Di Minno, M. et al. Rapid onset of Wernicke’s syndrome after gastric balloon positioning. Eur J Clin Nutr 66, 971 (2012). https://doi.org/10.1038/ejcn.2012.59

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