PDF(Pubmed)
Abstract：
In this case series, the simultaneous occurrence of Wernicke\'s encephalopathy (WE) and dry beriberi was reported in three patients who underwent vertical sleeve gastrectomy (VSG) between May 2021 and May 2023. All patients were obese women who underwent vertical sleeve gastrectomy (VSG) without immediate postoperative complications, but two weeks later, hyperemesis and subsequent encephalopathy with ocular movement abnormalities and weakness were observed over the following thirty days. Patients were referred to neurology, where due to the high suspicion of WE, thiamine replacement therapy was initiated; meanwhile, diagnostic neuroimaging and blood tests were conducted. Neurological and psychiatric evaluations and neuroconduction studies were performed to assess the clinical evolution and present sequelae. One year after diagnosis, all patients exhibited affective and behavioral sequelae, anterograde memory impairment, and executive functioning deficits. Two patients met the criteria for Korsakoff syndrome. Additionally, peripheral nervous system sequelae were observed, with all patients presenting with sensorimotor polyneuropathy. In conclusion, Wernicke\'s encephalopathy requires a high diagnostic suspicion for timely intervention and prevention of irreversible sequelae, which can be devastating. Therefore, raising awareness among medical professionals regarding the significance of this disease is essential.
摘要：
在这个系列中,据报道,在2021年5月至2023年5月期间接受垂直袖状胃切除术(VSG)的3例患者同时发生Wernicke脑病(WE)和干脚气病.所有患者均为肥胖女性，接受垂直袖状胃切除术（VSG），无术后立即并发症。但两周后,在接下来的三十天内观察到呕吐和随后的脑病，并伴有眼球运动异常和无力。病人被转诊到神经科，由于对我们的高度怀疑，开始硫胺素替代疗法；同时，进行了诊断性神经影像学检查和血液检查.进行了神经和精神病学评估以及神经传导研究，以评估临床演变和后遗症。确诊一年后,所有患者都表现出情感和行为后遗症，顺行记忆障碍,和执行功能缺陷。两名患者符合Korsakoff综合征的标准。此外,观察到周围神经系统后遗症，所有患者均表现为感觉运动性多发性神经病。总之,韦尼克脑病需要高度的诊断怀疑，以便及时干预和预防不可逆的后遗症，这可能是毁灭性的。因此,提高医疗专业人员对这种疾病重要性的认识至关重要。
