Liem Bernard, Tai Xin You, Begeti Faye, Fathima Farheen Fazal, Hofer Monika, Matthews Lucy, Rinaldi Simon, Bennett David L H, Turner Martin R
Neurology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Neuropathology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Pract Neurol. 2025 May 15;25(3):268-272. doi: 10.1136/pn-2024-004219.
Bariatric surgery is being undertaken more frequently in response to rising levels of obesity but is increasingly also requested as a cosmetic choice. Nutritional deficiencies are a recognised consequence of gastrectomy, with potentially severe and permanent neurological sequelae. We present two cases of acute, severe polyneuropathy following sleeve gastrectomy. Severe thiamine deficiency was considered in both cases but with delayed proof and a significant initial differential diagnosis. Neurologists must have a high index of suspicion for the peripheral as well as central presentations of thiamine deficiency to avoid permanent disability. We also call for explicit information resources warning of the risk and signs of thiamine deficiency to be provided routinely to patients after gastrectomy.
