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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 4/2010

01-08-2010

Micronutrient-Related Neurologic Complications Following Bariatric Surgery

Authors: Ali Kazemi, Thomas Frazier, Matt Cave

Published in: Current Gastroenterology Reports | Issue 4/2010

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Abstract

Nearly two thirds of American adults are either overweight or obese. Accordingly, bariatric surgery experienced explosive growth during the past decade. Current estimates place the worldwide volume of bariatric procedures at greater than 300,000 cases annually. Micronutrient deficiencies are well-described following bariatric surgery, and they may present with devastating and sometimes irreversible neurologic manifestations. Clinical symptoms range from peripheral neuropathy to encephalopathy, and are most commonly caused by thiamine, copper, and B12 deficiencies.
Literature
1.
Flegal KM, Carroll MD, Ogden CL, et al.: Prevalence and trends in obesity among US adults, 1999–2008. JAMA 2010, 303(3):235–241.CrossRefPubMed
2.
• Blackburn GL, Hutter MM, Harvey AM, et al.: Expert panel on weight loss surgery: executive report update. Obesity (Silver Spring) 2009, 17(5):842–862. This recent review provides an update of the bariatric surgery literature.CrossRef
3.
Buchwald H, Oien DM: Metabolic/bariatric surgery worldwide 2008. Obes Surg 2009, 19(12):1605–1611.CrossRefPubMed
4.
Abarbanel JM, Berginer VM, Osimani A, et al.: Neurologic complications after gastric restriction surgery for morbid obesity. Neurology 1987, 37(2):196–200.PubMed
5.
• Koffman BM, Greenfield LJ, Ali II, et al.: Neurologic complications after surgery for obesity. Muscle Nerve 2006, 33(2):166–176. This paper provides a comprehensive review of case reports documenting neurologic disease due to micronutrient deficiencies after bariatric surgery.CrossRefPubMed
6.
Schweiger C, Weiss R, Berry E, et al.: Nutritional deficiencies in bariatric surgery candidates. Obes Surg 2010, 20(2):193–197.CrossRefPubMed
7.
Coupaye M, Puchaux K, Bogard C, et al.: Nutritional consequences of adjustable gastric banding and gastric bypass: a 1-year prospective study. Obes Surg 2009, 19(1):56–65.CrossRefPubMed
8.
Gasteyger C, Suter M, Gaillard RC, et al.: 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(5):1128–1133.PubMed
9.
Chang CG, Adams-Huet B, Provost DA: Acute post-gastric reduction surgery (APGARS) neuropathy. Obes Surg 2004, 14(2):182–189.CrossRefPubMed
10.
• Jaiser SR, Winston GP: Copper deficiency myelopathy. J Neurol 2010 (Epub ahead of print). This paper reports on copper deficiency-related myelopathy in bariatric surgery patients.
11.
Juhasz-Pocsine K, Rudnicki SA, Archer RL, et al.: Neurologic complications of gastric bypass surgery for morbid obesity. Neurology 2007, 68(21):1843–1850.CrossRefPubMed
12.
Thaisetthawatkul P, Collazo-Clavell ML, Sarr MG, et al.: A controlled study of peripheral neuropathy after bariatric surgery. Neurology 2004, 63(8):1462–1470.PubMed
13.
Sassaris M, Meka R, Miletello G, et al.: Neuropsychiatric syndromes after gastric partition. Am J Gastroenterol 1983, 78(6):321–323.PubMed
14.
Bradley JE, Brown RO, Luther RW: Multiple nutritional deficiencies and metabolic complications 20 years after jejunoileal bypass surgery. JPEN J Parenter Enteral Nutr 1987, 11(5):494–498.CrossRefPubMed
15.
Limketkai BN, Zucker SD: Hyperammonemic encephalopathy caused by carnitine deficiency. J Gen Intern Med 2008, 23(2):210–213.CrossRefPubMed
16.
Singleton CK, Martin PR: Molecular mechanisms of thiamine utilization. Curr Mol Med 2001, 1(2):197–207.CrossRefPubMed
17.
•• Kumar N: Neurologic presentations of nutritional deficiencies. Neurol Clin 2010, 28(1):107–170. This manuscript is an excellent review of neurologic diseases related to nutritional deficiencies not limited to bariatric surgery patients.CrossRefPubMed
18.
19.
Hazell AS, Todd KG, Butterworth RF: Mechanisms of neuronal cell death in Wernicke’s encephalopathy. Metab Brain Dis 1998, 13(2):97–122.CrossRefPubMed
20.
Lakhani SV, Shah HN, Alexander K, et al.: Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res 2008, 28(5):293–298.CrossRefPubMed
21.
Clements RH, Katasani VG, Palepu R, et al.: Incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting. Am Surg 2006, 72(12):1196–1202; discussion 1203–1194.PubMed
22.
Carrodeguas L, Kaidar-Person O, Szomstein S, et al.: Preoperative thiamine deficiency in obese population undergoing laparoscopic bariatric surgery. Surg Obes Relat Dis 2005, 1(6):517–522; discussion 522.CrossRefPubMed
23.
Sechi G, Serra A: Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol 2007, 6(5):442–455.CrossRefPubMed
24.
Thomson AD, Marshall EJ: The natural history and pathophysiology of Wernicke’s encephalopathy and Korsakoff’s psychosis. Alcohol Alcohol 2006, 41(2):151–158.PubMed
25.
26.
Singh S, Kumar A: Wernicke encephalopathy after obesity surgery: a systematic review. Neurology 2007, 68(11):807–811.CrossRefPubMed
27.
Walker J, Kepner A: Wernicke’s encephalopathy presenting as acute psychosis after gastric bypass. J Emerg Med 2009 (Epub ahead of print).
28.
Aasheim ET: Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg 2008, 248(5):714–720.PubMed
29.
Al-Fahad T, Ismael A, Soliman MO, et al.: Very early onset of Wernicke’s encephalopathy after gastric bypass. Obes Surg 2006, 16(5):671–672.CrossRefPubMed
30.
Iannelli A, Addeo P, Novellas S, Gugenheim J: Wernicke’s encephalopathy after laparoscopic Roux-en-Y gastric bypass: a misdiagnosed complication. Obes Surg 2010 (Epub ahead of print).
31.
Malinowski SS: Nutritional and metabolic complications of bariatric surgery. Am J Med Sci 2006, 331(4):219–225.CrossRefPubMed
32.
Green R, Kinsella LJ: Current concepts in the diagnosis of cobalamin deficiency. Neurology 1995, 45(8):1435–1440.PubMed
33.
Metz J: Pathogenesis of cobalamin neuropathy: deficiency of nervous system S-adenosylmethionine? Nutr Rev 1993, 51(1):12–15.CrossRefPubMed
34.
Metz J: Cobalamin deficiency and the pathogenesis of nervous system disease. Annu Rev Nutr 1992, 12:59–79.CrossRefPubMed
35.
Scalabrino G: Cobalamin (vitamin B 12 ) in subacute combined degeneration and beyond: traditional interpretations and novel theories. Exp Neurol 2005, 192(2):463–479.CrossRefPubMed
36.
Reynolds EH: Neurological aspects of folate and vitamin B 12 metabolism. Clin Haematol 1976, 5(3):661–696.PubMed
37.
38.
Rhode BM, Tamin H, Gilfix BM, et al.: Treatment of vitamin B 12 deficiency after gastric surgery for severe obesity. Obes Surg 1995, 5(2):154–158.CrossRefPubMed
39.
Dudeja PK, Kode A, Alnounou M, et al.: Mechanism of folate transport across the human colonic basolateral membrane. Am J Physiol Gastrointest Liver Physiol 2001, 281(1):G54–60.PubMed
40.
Machado JD, Campos CS, Lopes Dah Silva C, et al.: Intestinal bacterial overgrowth after Roux-en-Y gastric bypass. Obes Surg 2008, 18(1):139–143.CrossRefPubMed
41.
42.
Vargas-Ruiz AG, Hernandez-Rivera G, Herrera MF: Prevalence of iron, folate, and vitamin B 12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2008, 18(3):288–293.CrossRefPubMed
43.
Reynolds EH: Benefits and risks of folic acid to the nervous system. J Neurol Neurosurg Psychiatry, 2002, 72(5):567–571.CrossRefPubMed
44.
de Silva P, Jayamanne G, Bolton R: Folic acid deficiency optic neuropathy: a case report. J Med Case Reports 2008, 2:299.CrossRefPubMed
45.
Slater GH, Ren CJ, Siegel N, et al.: Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg 2004, 8(1):48–55; discussion 54–45.CrossRefPubMed
46.
Madan AK, Orth WS, Tichansky DS, et al.: Vitamin and trace mineral levels after laparoscopic gastric bypass. Obes Surg 2006, 16(5):603–606.CrossRefPubMed
47.
Banerji NK, Hurwitz LJ: Nervous system manifestations after gastric surgery. Acta Neurol Scand 1971, 47(4):485–513.CrossRefPubMed
48.
Ueda N, Suzuki Y, Rino Y, et al.: Correlation between neurological dysfunction with vitamin E deficiency and gastrectomy. J Neurol Sci 2009, 287(1–2):216–220.CrossRefPubMed
49.
• Aigner E, Theurl I, Haufe H, et al.: Copper availability contributes to iron perturbations in human nonalcoholic fatty liver disease. Gastroenterology 2008, 135(2):680–688. This paper describes marginal copper deficiency in human nonalcoholic fatty liver disease.CrossRefPubMed
50.
Naismith RT, Shepherd JB, Weihl CC, et al.: Acute and bilateral blindness due to optic neuropathy associated with copper deficiency. Arch Neurol 2009, 66(8):1025–1027.CrossRefPubMed
Metadata
Title
Micronutrient-Related Neurologic Complications Following Bariatric Surgery
Authors
Ali Kazemi
Thomas Frazier
Matt Cave
Publication date
01-08-2010
Publisher
Current Science Inc.
Published in
Current Gastroenterology Reports / Issue 4/2010
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-010-0120-5

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