Jenkins Patricia F
From the Neuro-Ophthalmology of Texas Medical Clinic, Houston, Texas.
Am Orthopt J. 2015;65:104-8. doi: 10.3368/aoj.65.1.104.
This paper reviews the complaints and associated symptoms/consequences of lacking essential nutrients and vitamins in our central and peripheral nervous systems. This has become important as there has been a rise in malnutrition following the increasing incidence of bariatric surgery for obesity.
A case report example involving review of the clinical presentation and treatment.
A 30-year-old Caucasian woman who had gastric sleeve surgery did not take the recommended capsules as they were too large to swallow. She noted diplopia and oscillopsia 2 months later, which led her to have full orthoptic and neuro-ophthalmic evaluations. After being treated with chewable vitamins with thiamine, she noted a tremendous improvement in her symptoms.
Wernicke encephalopathy is a disease that was seen more in the 1940s and 1950s, following war times and mostly in underdeveloped countries. However, with the increasing utilization of bariatric surgery for obesity, neurological offices are seeing more patients with neurological impairments. We recommend inquiring about any obesity surgery in one's history and including Wernicke encephalopathy in possible differential diagnoses in those patients who have a recent onset of strabismus or nystagmus, altered mental status, and/or gait ataxia.
本文回顾了中枢神经系统和周围神经系统缺乏必需营养素和维生素的相关症状及后果。随着肥胖症患者接受减肥手术的发病率增加，营养不良现象也有所上升，这一问题变得越发重要。
通过一个病例报告实例，回顾临床表现及治疗情况。
一名30岁接受胃袖状切除术的白人女性，因推荐服用的胶囊太大无法吞咽而未服用。2个月后，她出现复视和视振荡，随后接受了全面的视光学和神经眼科评估。在服用含硫胺素的咀嚼型维生素进行治疗后，她的症状有了显著改善。
韦尼克脑病在20世纪40年代和50年代较为常见，多发生在战时及大多数不发达国家。然而，随着减肥手术在肥胖症治疗中的应用增加，神经科门诊出现了更多有神经功能障碍的患者。我们建议询问患者既往是否接受过肥胖症手术，并将韦尼克脑病纳入近期出现斜视或眼球震颤、精神状态改变和/或步态共济失调患者的可能鉴别诊断中。
