Division of Neurology, Department of Internal Medicine, King Abdulaziz University Hospital and College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Division of Neurology, Department of Internal Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia.
Eur Neurol. 2019;81(5-6):239-245. doi: 10.1159/000503286. Epub 2019 Oct 8.
The syndrome of post-bariatric surgery axonal polyneuropathy (PAP) may present with various sensory and motor symptoms including paralysis. We aim to describe the diagnostic features and outcome of treatment of the acute paralytic form of PAP (acute paralytic PAP [APPAP]) as it was not described in a separate cohort previously.
We retrospectively reviewed medical charts and described the clinical, electrodiagnostic features, treatment, and outcome for patients who presented to our clinical neurophysiology unit with disabling weakness within 24 months post-bariatric surgery. The main outcome measure was the percent of patients who are able to walk independently at the last visit and comparing the group who resumed walking independently at 6 months to the group who did not, in regards to the use of intravenous immunoglobulin (IVIg).
Thirteen patients were included (10 women and 3 men) with a mean age of 29.8 years (SD 12.5). All presented with loss of ambulation resembling Guillain-Barre Syndrome. The median time of onset was 4 months (interquartile range [IQR] 3-6) post-surgery, and the median time to weakness nadir was 3 weeks (IQR 3-3.5) with an average weight loss of 38.6 kg (SD 17.09). All patients regained their ability to ambulate; however, the ability to walk independently was achieved in 66.7% of patients. The percent of patients who were able to ambulate independently at 6 months were 16% with IVIg versus 66.7% without IVIg.
The syndrome of -APPAP develops in the first-year post-bariatric surgery. The majority of patients regain independent ambulation.
减重手术后轴索性多神经病（PAP）综合征可能表现出各种感觉和运动症状，包括瘫痪。我们旨在描述急性麻痹性 PAP（急性麻痹性 PAP [APPAP]）的诊断特征和治疗结果，因为以前在单独的队列中没有描述过这种疾病。
我们回顾性地审查了病历，并描述了在减重手术后 24 个月内因残疾性无力而就诊于我们临床神经生理学单位的患者的临床、电诊断特征、治疗和结局。主要结局指标是最后一次就诊时能够独立行走的患者百分比，并比较在 6 个月时恢复独立行走的患者与未恢复的患者在使用静脉注射免疫球蛋白（IVIg）方面的差异。
共纳入 13 例患者（10 名女性和 3 名男性），平均年龄为 29.8 岁（SD 12.5）。所有患者均表现为类似于格林-巴利综合征的行走能力丧失。发病中位时间为手术后 4 个月（四分位距 [IQR] 3-6），无力最低点的中位时间为 3 周（IQR 3-3.5），平均体重减轻 38.6 公斤（SD 17.09）。所有患者均恢复了行走能力；然而，仅有 66.7%的患者能够独立行走。在 6 个月时能够独立行走的患者百分比为 IVIg 组 16%，无 IVIg 组 66.7%。
-APPAP 综合征在减重手术后的第一年发展。大多数患者恢复了独立行走的能力。
