Neuro-Ophthalmic Findings in Wernicke's Encephalopathy after Gastric Bypass Surgery

Abstract

Three patients with acquired neuro-ophthalmic abnormalities due to Wernicke's encephalopathy following gastric bypass surgery are reported. The neuro-ophthalmic findings included bilateral third nerve palsies, horizontal and vertical nystagmus, and lid nystagmus. Two of our patients were not eating and two were actually vomiting when the eye movement abnormalities appeared. Thirteen similar cases have been reported. The frequency of this complication heralds a call for closer attention to the nutritional state of patients undergoing bariatric surgery. Clinicians should be aware of the possibility of Wernicke's encephalopathy after gastric bypass surgery.

KEYWORDS:

• Wernicke's encephalopathy
• gastric bypass surgery