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The Risks of Weight Loss Surgery and Brain Damage

04.10.2007

When a patient has weight loss surgery it is a major ordeal. After weight loss surgery, some of the patients risk brain damage from vitamin B-1 deficiency. This is what some of the research is finding.

When treated right away with vitamin b-1 shots, some patients will soon recover. If the syndrome is not recognized quickly, it can end up in a permanent brain damage situation.

This can be a problem says Wake Forest University researcher Sonal Singh, MD. Singh and Abhay Jumar, MD of the University of Iowa and found 32 reports of Wernicke’s encephalopathy in weight loss surgery patients.

“The Early diagnoses is essential," Singh tells WebMD. " Yes, thiamine shots are helpful. You can fully recover only when it is given early. Once it is developed there is going to be neurological damage."

Singh and Kumar have reported what they found in the March 13 issue f the Journal Neurology.

Symptoms that will Trick You

Wernicke’s encephalopathy has three main symptoms: jerky, uncoordinated movement, uncontrollable eye movements, and metal confusion. This may sound too easy to recognize. It is not all weight loss surgery patients that develop the syndrome and get all three symptoms. Some patients have unusual symptoms like hearing loss, weakness, convulsions, and numbness or tingles in their arms and legs.

Symptoms of Wernicke’s encephalopathy will usually occur for to 12 weeks after weight loss surgery. However one case can begin a year after surgery and another can start only two weeks after the surgery. There is one good warning sign for weight loss surgery patients to recognize and this is vomiting. There are at least 25 patients that were reported to vomit after their surgery.

Not all of the patients had this problem and many developed vitamin B-1 deficiency even though they were taking oral thiamine supplements and suggesting that deficiencies in other nutrients may also play a role in it.

How often does weight loss surgery patients get Wernicke’s encephalopathy? It is not known yet. Singh says that it is an issue that needs to be studied. " Maybe giving shots of thiamine after surgery would prevent this," Singh says. "We might do it preventively rather than waiting for symptoms to appear. That needs to be studied." Bariatric surgeon Ioannis Raftopoulos, MD who is the assistant professor of surgery at the University of Pittsburgh, says hat he regularly monitors thiamine levels in his patients life and gives his patients thiamine supplements on either an orally or by monthly injection.

The result of this is that Raftopoulos says that he has never had a patient develop Wernicke’s encephalopathy.

"This kind of thing will only happen when a patient has been vomiting for two weeks," Raftopoulos tells WebMD. "That kind of neurological impairment means that a patient has had a lo of problems in their life for a long time. That is why it is important to have a follow up. All of my patients have my personal beeper number so they can contact me immediately before there is a serious problem."

Singh says patients should immediately call a doctor if, after weight loss surgery, they have some coordination problems and changes in their gait or any changes in their hearing or vision.