TY - JOUR
T1 - Wernicke encephalopathy in subjects undergoing restrictive weight loss surgery
T2 - A systematic review of literature data
AU - Milone, Marco
AU - Di Minno, Matteo Nicola Dario
AU - Lupoli, Roberta
AU - Maietta, Paola
AU - Bianco, Paolo
AU - Pisapia, Anna
AU - Gaudioso, Dario
AU - Taffuri, Caterina
AU - Milone, Francesco
AU - Musella, Mario
PY - 2014
Y1 - 2014
N2 - The use of weight loss surgery is progressively increasing, and in recent years, restrictive bariatric surgery procedures have been more often used. Although thought to be associated with a lower incidence of post-operative side effects than malabsorpitive surgery, some cases of micronutrients deficiency have been reported because of an acquired thiamine deficiency; in this clinical setting, some cases of Wernicke encephalopathy (WE) have been described. Major determinants and predictors of this major neurological complication are currently unknown. The aim of this systematic review was to analyse literature data in order to address this issue. The main result of our systematic review was that persistent vomiting is the major determinant of WE in patients undergoing restrictive weight loss surgery. In addition, early thiamine supplementation can rapidly improve the clinical conditions, avoiding permanent deficiencies. On the other hand, given the wide variability of clinical and demographic characteristics, definite prognostic factors of WE occurrence and of clinical outcome cannot be identified. In conclusion, although our results are suggestive, further ad hoc prospective studies evaluating changes in micronutrients levels according to different types of surgery are needed.
AB - The use of weight loss surgery is progressively increasing, and in recent years, restrictive bariatric surgery procedures have been more often used. Although thought to be associated with a lower incidence of post-operative side effects than malabsorpitive surgery, some cases of micronutrients deficiency have been reported because of an acquired thiamine deficiency; in this clinical setting, some cases of Wernicke encephalopathy (WE) have been described. Major determinants and predictors of this major neurological complication are currently unknown. The aim of this systematic review was to analyse literature data in order to address this issue. The main result of our systematic review was that persistent vomiting is the major determinant of WE in patients undergoing restrictive weight loss surgery. In addition, early thiamine supplementation can rapidly improve the clinical conditions, avoiding permanent deficiencies. On the other hand, given the wide variability of clinical and demographic characteristics, definite prognostic factors of WE occurrence and of clinical outcome cannot be identified. In conclusion, although our results are suggestive, further ad hoc prospective studies evaluating changes in micronutrients levels according to different types of surgery are needed.
KW - encephalopathy
KW - restrictive bariatric surgery
KW - weight loss surgery
KW - Wernicke
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U2 - 10.1002/erv.2292
DO - 10.1002/erv.2292
M3 - Article
C2 - 24764323
AN - SCOPUS:84902362649
VL - 22
SP - 223
EP - 229
JO - European Eating Disorders Review
JF - European Eating Disorders Review
SN - 1072-4133
IS - 4
ER -