Encéphalopathie de Gayet-Wernicke après gastrectomie partielle pour obésité morbide

Gabaudan, C.; Lafolie, T.; Sagui, Emmanuel; Soulier, B.; Dion, Angélina; Richez, P.; Brosset, C.

doi:10.1016/j.neurol.2008.01.006

Cited by 9 publications

(3 citation statements)

References 15 publications

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“…Dietary thiamine acts as a cofactor of several enzymes involved in the Krebs cycle and the phosphate pentose cycle [ 9 ]. Their deficiency is the cause of focal lactic acidosis due to insufficient brain energy, leading to an alteration of the blood–brain barrier and cell death by necrosis and apoptosis [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Initially reported in malnourished alcoholic patients, this condition can be seen in any situation causing severe undernutrition, including hyperemesis gravidarum, thyrotoxicosis, peptic ulcer and stomach cancer, duodenal or jejunal resection, bariatric surgery, anorexia nervosa, prolonged fasting, and prolonged parenteral nutrition [5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

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Gayet-Wernicke’s encephalopathy complicating prolonged parenteral nutrition in patient treated for colonic cancer – a case report –

et al. 2022

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Background Gayet-Wernicke’s encephalopathy (GWE) is a neurological pathology caused by a Thiamine deficiency. While it is most often related to chronic alcoholism, GWE can occur in any situation that results in thiamine deficiency. It is a fairly common pathology that is frequently underdiagnosed and therefore under-treated, and is associated with a high mortality and morbidity rate. In the absence of pathognomonic signs, the diagnosis of GWE relies on a range of clinical, biological and radiological assessments. GWE is considered a medical emergency. We present a case of Gayet-Wernicke’s Encephalopathy resulting from complete parenteral nutrition in an undernourished North African male operated for a left colon tumor. Through this report, our aim was to put the light on this often underknown disease and to remind the interest of thinking about this pathology in patients at risk of undernourishment especially in oncology. Case presentation A 66-year-old North African male with no personal or family history was operated for a sigmoid colon tumor. He was put on exclusive parenteral nutrition on day thirteen post-operatively and presented with a GWE on day sixteen post-operatively. The patient was treated with intravenous vitamin B1 on day eighteen post-operatively and deceased on day twenty-four post-operatively. Conclusions Although most often associated with chronic alcoholism, GWE occurs in any situation where there is an increased energy demand or decreased nutritional intake especially in oncology. GWE is common but under-diagnosed and remains lethal if not treated urgently, hence the importance of prophylactic treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gayet-Wernicke’s encephalopathy complicating prolonged parenteral nutrition in patient treated for colonic cancer – a case report –

et al. 2022

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“…Malabsorptive procedures have been reported as having more sustainable long-term results in terms of weight loss and amelioration of related comorbidities compared to restrictive procedures, in exchange for more common post-operative nutritional deficiencies [3]. Restrictive procedures on the other hand are linked with a progressively attenuated weightloss and metabolic result but have a more favorable long -term nutritional profile [4], [5], [6], [7] Sleeve gastrectomy is currently the most commonly used bariatric procedure worldwide due to its very good immediate and quite promising long-term results [8] [9], [10] , [4]. Concerning its potential longterm nutritional disorders, it has been reported to have a safe profile, with Ferrum, calcium, and vitamin D deficiencies being the most commonly reported problems [7].…”

Section: Introductionmentioning

confidence: 99%

Wernicke encephalopathy after sleeve gastrectomy. A review of the literature

Angelou

Athanasiou

Diamantis

et al. 2017

JDDD

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Objectives:Bariatric surgery has been established as the cornerstone of treatment of morbid obesity with good immediate and long-term results. Nutrient deficiencies though, can be an important long-term complication and may lead to hematological, metabolic and especially neurological disorders which are not always reversible. Thiamine (vitamin B1) deficiency has been reported both after restrictive and malabsorptive procedures. The aim of this study is to review all cases that presented with Wernicke Encephalopathy after sleeve gastrectomy. Methods:A review of the literature was conducted to evaluate all sleeve gastrectomies performed till today and caused Wernicke encephalopathy to the patients. Demographic data, operative parameters, postoperative outcomes were collected and assessed. Results:A total of 13 studies, including 13 patients were analyzed. Patients ranged in age from 17 to 55 years. The onset of Wernicke encephalopathy occurred as early as 3 weeks after surgery to as late as 60 weeks after surgery. When symptoms of Wernicke encephalopathy developed, patients had lost from 19 kg up to 60 kg of body weight. Conclusions:Micronutrient deficiencies and particularly B1 deficiency can occur after LSG, although rarely. Preoperative nutritional assessment and postoperative follow-up plan, should signs of Wernicke's encephalopathy be traced, is recommended in all patients.

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Wernicke’s Encephalopathy: Expanding the Diagnostic Toolbox

Lough

2012

Neuropsychol Rev

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Wernicke's encephalopathy (WE) is a life threatening neurological disorder that results from thiamine (Vitamin B1) deficiency. Clinical signs include mental status changes, ataxia, occulomotor changes and nutritional deficiency. The conundrum is that the clinical presentation is highly variable. WE clinical signs, brain imaging, and thiamine blood levels, are reviewed in 53 published case reports from 2001 to 2011; 81 % (43/53) were non-alcohol related. Korsakoff Syndrome or long-term cognitive neurological changes occurred in 28 % (15/53). Seven WE cases (13 %) had a normal magnetic resonance image (MRI). Four WE cases (8 %) had normal or high thiamine blood levels. Neither diagnostic tool can be relied upon exclusively to confirm a diagnosis of WE.

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Encéphalopathie de Gayet-Wernicke après gastrectomie partielle pour obésité morbide

Cited by 9 publications

References 15 publications

Gayet-Wernicke’s encephalopathy complicating prolonged parenteral nutrition in patient treated for colonic cancer – a case report –

Gayet-Wernicke’s encephalopathy complicating prolonged parenteral nutrition in patient treated for colonic cancer – a case report –

Wernicke encephalopathy after sleeve gastrectomy. A review of the literature

Wernicke’s Encephalopathy: Expanding the Diagnostic Toolbox

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