A new etiology for variant of Guillain-Barré syndrome: bariatric surgery
Abstract
Bariatric surgery is an effective treatment for obesity. However, the number of acute or chronic neurological complications after bariatric surgery, including Guillain-Barré syndrome, is increasingly reported. We present here two cases which developed acute motor sensory polyneuropathy a couple months after bariatric surgery which rapidly progressed over the following month. Both patients used received parenteral vitamin B complex replacement after surgery. The first case responded well to intravenous immunoglobulin (IVIg) treatment. However, the second case required plasmapheresis and physical rehabilitation for recovery after IVIg treatment. It is thought that minerals, vitamins, and trace element deficiencies can develop after bariatric surgery. These deficiencies may trigger inflammatory and autoimmune mechanisms and cause acute polyneuropathies. In such cases, it should be kept in mind that immune therapies may be beneficial, as well as vitamins.
Keywords
References
- [1] Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg 2009;19:1605-11.
- [2] Centre for Public Health Excellence at NICE (UK), National Collaborating Centre for Primary Care (UK): Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. London 2006.
- [3] NIH Consensus Development Conference Panel: Gastrointestinal surgery for severe obesity. Ann Intern Med 1991;115:956-61.
- [4] Lawton AW, Frisard NE. Visual loss, retinal hemorrhages, and optic disc edema resulting from thiamine deficiency following bariatric surgery complicated by prolonged vomiting. Ochsner J 2017;17:112-4.
- [5] Goodman JC. Neurological complications of bariatric surgery. Curr Neurol Neurosci Rep 2015;15:79.
- [6] Papamargaritis D, Aasheim ET, Sampson B, le Roux CW. An overview of complications affecting the copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation. J Trace Elem Med Biol 2015;31:167-72.
- [7] Kazemi A, Frazier T, Cave M. Micronutrient related neurologic complications following bariatric surgery. Curr Gastroenterol Rep 2010;12:4:288-95.
- [8] Punchai S, Hanipah ZN, Meister KM, Schauer PR, Brethauer SA, Aminian A. Neurologic nmnifestations of vitamin B deficiency after bariatric surgery. Obes Surg 2017;27:2079-82.
Details
Primary Language
English
Subjects
Surgery, Endocrinology, Neurosciences
Journal Section
Case Report
Authors
Şevki Şahin
0000-0003-2016-9965
Türkiye
Nilgün Çınar
This is me
0000-0003-3868-3137
Türkiye
Sibel Karşıdağ
This is me
0000-0002-2887-9235
Türkiye
Publication Date
November 4, 2019
Submission Date
September 20, 2018
Acceptance Date
December 11, 2018
Published in Issue
Year 2019 Volume: 5 Number: 6