Encefalopatía de Wernicke y polineuropatía asociada a déficit de complejo B después de una cirugía bariátrica
Resumen
La cirugía bariátrica es un tratamiento que garantiza una pérdida de peso sustancial y duradera, y beneficios tangibles respecto a condiciones médicas asociadas a la obesidad. El aumento del número de cirugías bariátricas ha llevado también a un aumento de las complicaciones relacionadas con ella, incluyendo la encefalopatía de Wernicke y la polineuropatía por deficiencia de vitaminas del complejo B.
En este artículo se reporta un caso de encefalopatía de Wernicke siete semanas después de la cirugía, enfatizando en la importancia de reconocer el espectro de la sintomatología para hacer un diagnóstico temprano, que permita intervenir en la fase reversible de esta enfermedad potencialmente letal.
Descargas
Referencias bibliográficas
Aasheim ET. Wernicke encephalopathy after bariatric surgery: A systematic review. Ann Surg. 2008;248:714-20.
Bal B, Koch TR, Finelli FC, Sarr MG. Managing medical and surgical disorders after divided Roux-en-Y gastric bypass surgery. Nat Rev Gastroenterol Hepatol. 2010;7:320-34. http://dx.doi.org/10.1038/nrgastro.2010.60.
Ba F, Siddiqi ZA. Neurologic complications of bariatric surgery. Rev Neurol Dis. 2010;7:119-24. http://dx.doi.org/10.1001/archneur.61.8.1185.
Pournaras D, le Roux C. After bariatric surgery, what vitamins should be measured and what supplements should be given? Clin Endocrinol (Oxf). 2009;71:322-5. http://dx.doi.org/10.1111/j.1365-2265.2009.03564.x
Koffman BM, Greenfield LJ, Ali II, Pirzada NA. Neurologic complications after surgery for obesity. Muscle Nerve. 2006;33:166-76. http://dx.doi.org/10.1002/mus.20394
Thaisetthawatkul P, Collazo-Clavell ML, Sarr MG, Norell JE, Dyck PJ. Good nutritional control may prevent polyneuropathy after bariatric surgery. Muscle Nerve. 2010;42:709-14. http://dx.doi.org/10.1002/mus.21802
Ziegler O, Sirveaux MA, Brunaud L, Reibel N, Quilliot D. Medical follow up after bariatric surgery: Nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009;35:544-57. http://dx.doi.org/10.1016/S1262-3636(09)73464-0
Singh S, Kumar A. Wernicke encephalopathy after obesity surgery: A systematic review. Neurology. 2007;68:807-11. http://dx.doi.org/10.1212/01.wnl.0000256812.29648.86
Mechanick JI, Kushner RF, Sugerman HJ, González-Campoy JM, Collazo-Clavell ML, Spitz AF. American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient: Perioperative Bariatric Guidelines. Obesity. 2009;17:1-70. http://dx.doi.org/10.1038/oby.2009.28.
Aluka KJ, Turner PL, Fullum TM. Guillain-Barré syndrome and postbariatric surgery polyneuropathies. JSLS. 2009;13:250-3.
Koike H, Ito S, Morozumi S, Kawagashira Y, Iijima M, Hattori N, et al. Rapidly developing weakness mimicking Guillain-Barré syndrome in beriberi neuropathy: Two case reports. Nutrition. 2008;24:776-80. http://dx.doi.org/10.1016/j.nut.2008.02.022
Teitleman M, Katzka DA. A case of polyneuropathy after gastric bypass surgery. MedGenMed. 2005;7:21.
Thaisetthawatkul P, Collazo-Clavell ML, Sarr MG, Norell JE, Dyck PJ. A controlled study of peripheral neuropathy after bariatric surgery. Neurology. 2004;63:1462-70.
Donnino M, Miller J, Walsh M, Vega J. Myths and misconceptions of Wernicke’s encephalopathy: What every emergency physician should know. Ann Emerg Med. 2007;50:715-21. http://dx.doi.org/10.1016/j.annemergmed.2007.02.007
Cirignotta F, Manconi M, Mondini S, Buzzi G, Ambrosetto P. Wernicke-Korsakoff encephalopathy and polyneuropathy after gastroplasty for morbid obesity: Report of a case. Arch Neurol. 2000;57:1356-9. http://dx.doi.org/10-1001/pubs.Arch Neurol.-ISSN-0003-9942-57-9-nob90055.
Aasheim E, Hofsø D, Søvik T. Vitamin supplements after bariatric surgery: Response to the editor. Clin Endocrinol (Oxf). 2009;72:133-6.
Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2010;28:107-70. http://dx.doi.org/10.1016/j.
ncl.2009.09.006
Wilson RK, Kuncl RW, Corse AM. Wernicke’s encephalopathy: Beyond alcoholism. Nat Clin Pract Neurol. 2006;2:54-8. http://dx.doi.org/10.1038/ncpneuro0094
Sechi GP, Serra A. Wernicke’s encephalopathy: New clinical settings and recent advances in diagnosis and management. Lancet Neurol. 2007;6:442-55. http://dx.doi.org/10.1016/S1474-4422(07)70104-7
Donnino MW, Miller J, García AJ, McKee E, Walsh M. Distinctive acid-base pattern in Wernicke’s encephalopathy. Ann Emerg Med. 2007;50:722-5. http://dx.doi.org/10.1016/j.annemergmed.2006.10.022
Fei GQ, Zhong C, Jin L, Wang J, Zhang Y, Zheng X, et al. Clinical characteristics and MR imaging features of nonalcoholic Wernicke encephalopathy. Am J Neuroradiol. 2008;29:164-9. http://dx.doi.org/10.3174/ajnr.A0827
Zhong C, Jin L, Fei G. MR Imaging of nonalcoholic Wernicke encephalopathy: A follow-up study. Am J Neuroradiol. 2005;26:2301-5.
Kumar V, Fausto N, Abbas A. The central nervous system. En: Robbins and Cotran pathologic basis of disease. 8th edition. Philadelphia, PA: Saunders-Elsevier; 2009. p. 1328-9.
Foster D, Falah M, Kadom N, Mandler R. Wernicke encephalopathy after bariatric surgery: Losing more than just weight. Neurology. 2005;65:1987.
Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol. 2010;17:1408-18. http://dx.doi.org/10.1111/j.1468-1331.2010.03153.x
Longmuir R. Visual loss due to Wernicke syndrome following gastric bypass. Semin Ophthalmol. 2007;22:13-9. http://dx.doi.org/10.1080/08820530601182733
Nakamura K, Roberson ED, Reilly LG, Tsao JW. Polyneuropathy following gastric bypass surgery. Am J Med. 2003;115:679-80. http://dx.doi.org/10.1016/j.amjmed.2003.05.002
Hsia A, Hattab E, Katz J. Malnutrition-induced myopathy following Roux-en-y gastric bypass. Muscle Nerve. 2001;24:1692-4. http://dx.doi.org/10.1002/mus.1204
Sechi GP. Prognosis and therapy of Wernicke’s encephalopathy after obesity surgery: Letters to the editor. Am J Gastroenterol. 2008;103:3219. http://dx.doi.org/10.1111/j.1572-0241.2008.02161_19.x
Bhardwaj A, Watanabe M, Shah JR. A 46-year-old woman with ataxia and blurred vision 3 months after bariatric surgery. Am J Gastroenterol. 2008;103:1575-7. http://dx.doi.org/10.1111/j.1572-0241.2008.01880_10.x
Juhasz-Pocsine K, Rudnicki SA, Archer RL, Harik SI. Neurologic complications of gastric bypass surgery for morbid obesity. Neurology. 2007;68:1843-50. http://dx.doi.org/10.1212/01.wnl.0000262768.40174.33
Menezes MS, Harada KO, Álvarez G. Painful peripheral polyneuropathy after bariatric surgery: Case reports. Rev Bras Anestesiol. 2008;58:252-9. http://dx.doi.org/10.1590/S0034-70942008000300008
Zuccoli G, Gallucci M, Capellades J, Regnicolo L, Tumiati B, Cabada Giada T, et al. Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients. Am J Neuroradiol. 2007;28:1328-31. http://dx.doi.org/10.3174/ajnr.A0544
Zuccoli G, Santa Cruz D, Bertolini M, Rovira A, Gallucci M, Carollo C. MR imaging findings in 56 patients with Wernicke encephalopathy: Nonalcoholics may differ from alcoholics. AJNR Am J Neuroradiol. 2009;30:171-6. http://dx.doi.org/10.3174/ajnr.A1280
Gasteyger C, Suter M, Gaillard RC, Giusti V. Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr. 2008;87:1128-33.
Sechi GP. Peculiarities of Wernicke encephalopathy after bariatric surgery: Response to the editor. Ann Surg. 2009;249:1066. http://dx.doi.org/10.1097/SLA.0b013e 3181a8860e
| Estadísticas de artículo | |
|---|---|
| Vistas de resúmenes | |
| Vistas de PDF | |
| Descargas de PDF | |
| Vistas de HTML | |
| Otras vistas | |
