Machado Flavia Costa Nunes, Valério Berenice Cataldo Oliveira, Morgulis Roberto Naun Franco, Nunes Karlo Faria, Mazzali-Verst Sílvia
Department of Clinical Neurophysiology, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Arq Neuropsiquiatr. 2006 Sep;64(3A):609-12. doi: 10.1590/s0004-282x2006000400017.
Bariatric surgery is frequently indicated in the treatment of morbid obesity. Previously unreported complications have been associated to this surgery; among them, neurological complications have gained attention. We report the case of a 25-year-old man submitted to gastric surgery for treatment of morbid obesity who developed, two months after surgery, acute proximal weakness in lower limbs. The electroneuromyography revealed axonal peripheral polyneuropathy with predominant proximal involvement. After treatment with immunoglobulin and vitamin supplementation, rapid clinical and neurophysiologic recovery was observed. We describe the clinical and electroneuromyographic features of this case, stressing the difficulty of initial diagnosis, particularly in the differential diagnosis with Guillain-Barré syndrome. We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients.
减肥手术常用于治疗病态肥胖。此前有未报道的并发症与该手术相关；其中，神经系统并发症已受到关注。我们报告一例25岁男性患者，因病态肥胖接受胃部手术，术后两个月出现下肢急性近端无力。肌电图显示为轴索性周围性多发性神经病，以近端受累为主。经免疫球蛋白和维生素补充治疗后，临床和神经生理学迅速恢复。我们描述了该病例的临床和肌电图特征，强调了初始诊断的困难，尤其是与吉兰-巴雷综合征的鉴别诊断。我们讨论了营养随访的重要性以及这些患者常规补充维生素的最终指征。
