Bathobakae Lefika, Ozgur Sacide S, Lombardo Danielle, Mekheal Nader, Michael Patrick
Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA.
Medical Education, St. George's University School of Medicine, St. Georgestown, GRD.
Cureus. 2023 Apr 3;15(4):e37056. doi: 10.7759/cureus.37056. eCollection 2023 Apr.
Wernicke encephalopathy (WE) is an acute neurological syndrome caused by thiamine (vitamin B1) deficiency. This disorder manifests as a triad of gait ataxia, confusion, and vision abnormalities. The absence of a full triad does not rule out WE. Because of its vague presentation, WE is commonly missed in patients with no history of alcohol abuse. Other risk factors for WE include bariatric surgery, hemodialysis, hyperemesis gravidarum, and malabsorption syndromes. WE is a clinical diagnosis that can be confirmed with an MRI of the brain as hyperintensities in the mammillary bodies, periaqueductal area, thalami, and hippocampus. If suspected in a patient, WE must be immediately treated with intravenous thiamine to prevent evolution into Korsakoff syndrome, coma, or death. Currently, there is no consensus in the medical community as to how much thiamine must be given and for how long. Therefore, there is a need for more research in the diagnosis and management of WE after bariatric surgery. Herein, we report a rare case of a 23-year-old female with a history of morbid obesity who developed WE two weeks after a laparoscopic sleeve gastrectomy.
韦尼克脑病（WE）是一种由硫胺素（维生素B1）缺乏引起的急性神经综合征。这种疾病表现为步态共济失调、意识模糊和视力异常三联征。缺乏完整的三联征并不能排除韦尼克脑病。由于其表现模糊，在无酗酒史的患者中，韦尼克脑病常被漏诊。韦尼克脑病的其他危险因素包括减肥手术、血液透析、妊娠剧吐和吸收不良综合征。韦尼克脑病是一种临床诊断，可通过脑部MRI证实乳头体、导水管周围区域、丘脑和海马体出现高信号。如果怀疑患者患有韦尼克脑病，必须立即静脉注射硫胺素进行治疗，以防止发展为科萨科夫综合征、昏迷或死亡。目前，医学界对于必须给予多少硫胺素以及给予多长时间尚无共识。因此，需要对减肥手术后韦尼克脑病的诊断和管理进行更多研究。在此，我们报告一例罕见病例，一名23岁有重度肥胖病史的女性，在腹腔镜袖状胃切除术后两周发生了韦尼克脑病。
