The neurologic form of beriberi has been described in multiple case reports following bariatric surgery for morbid obesity. Thiamine deficiency occurs due to marked emesis and/or altered absorption secondary to the reconfiguration of the gastrointestinal tract to achieve the malabsorption needed to achieve weight loss. This case report illustrates the typical presentation of a patient after gastric bypass, and highlights the symptoms that bariatric surgeons must detect and reviews the treatment.
A 64-year-old woman had bilateral facial weakness, mild peripheral neuropathy, incoordination, and impaired balance. A corneal transplant had been performed for corneal lattice dystrophy. Sural nerve biopsy showed mild axonal neuropathy with deposits of amyloid in the perineurium. Histochemical studies showed amyloid protein AA in the nerve, but not in cornea or muscle.
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