Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery

Bariatric surgery is frequently indicated in the treatment of morbid obesity. Previously unreported complications have been associated to this surgery; among them, neurological complications have gained attention. We report the case of a 25-year-old man submitted to gastric surgery for treatment of morbid obesity who developed, two months after surgery, acute proximal weakness in lower limbs. The electroneuromyography revealed axonal peripheral polyneuropathy with predominant proximal involvement. After treatment with immunoglobulin and vitamin supplementation, rapid clinical and neurophysiologic recovery was observed. We describe the clinical and electroneuromyographic features of this case, stressing the difficulty of initial diagnosis, particularly in the differential diagnosis with Guillain-Barré syndrome. We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients.

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Main Authors: Machado,Flavia Costa Nunes, Valério,Berenice Cataldo Oliveira, Morgulis,Roberto Naun Franco, Nunes,Karlo Faria, Mazzali-Verst,Sílvia
Format: Digital revista
Language:English
Published: Academia Brasileira de Neurologia - ABNEURO 2006
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000400017
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spelling oai:scielo:S0004-282X20060004000172006-09-28Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgeryMachado,Flavia Costa NunesValério,Berenice Cataldo OliveiraMorgulis,Roberto Naun FrancoNunes,Karlo FariaMazzali-Verst,Sílvia bariatric surgery polyneuropathy neurological complications vitamin supplementation Bariatric surgery is frequently indicated in the treatment of morbid obesity. Previously unreported complications have been associated to this surgery; among them, neurological complications have gained attention. We report the case of a 25-year-old man submitted to gastric surgery for treatment of morbid obesity who developed, two months after surgery, acute proximal weakness in lower limbs. The electroneuromyography revealed axonal peripheral polyneuropathy with predominant proximal involvement. After treatment with immunoglobulin and vitamin supplementation, rapid clinical and neurophysiologic recovery was observed. We describe the clinical and electroneuromyographic features of this case, stressing the difficulty of initial diagnosis, particularly in the differential diagnosis with Guillain-Barré syndrome. We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia - ABNEUROArquivos de Neuro-Psiquiatria v.64 n.3a 20062006-09-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000400017en10.1590/S0004-282X2006000400017
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country Brasil
countrycode BR
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databasecode rev-scielo-br
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libraryname SciELO
language English
format Digital
author Machado,Flavia Costa Nunes
Valério,Berenice Cataldo Oliveira
Morgulis,Roberto Naun Franco
Nunes,Karlo Faria
Mazzali-Verst,Sílvia
spellingShingle Machado,Flavia Costa Nunes
Valério,Berenice Cataldo Oliveira
Morgulis,Roberto Naun Franco
Nunes,Karlo Faria
Mazzali-Verst,Sílvia
Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
author_facet Machado,Flavia Costa Nunes
Valério,Berenice Cataldo Oliveira
Morgulis,Roberto Naun Franco
Nunes,Karlo Faria
Mazzali-Verst,Sílvia
author_sort Machado,Flavia Costa Nunes
title Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
title_short Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
title_full Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
title_fullStr Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
title_full_unstemmed Acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
title_sort acute axonal polyneuropathy with predominant proximal involvement: an uncommon neurological complication of bariatric surgery
description Bariatric surgery is frequently indicated in the treatment of morbid obesity. Previously unreported complications have been associated to this surgery; among them, neurological complications have gained attention. We report the case of a 25-year-old man submitted to gastric surgery for treatment of morbid obesity who developed, two months after surgery, acute proximal weakness in lower limbs. The electroneuromyography revealed axonal peripheral polyneuropathy with predominant proximal involvement. After treatment with immunoglobulin and vitamin supplementation, rapid clinical and neurophysiologic recovery was observed. We describe the clinical and electroneuromyographic features of this case, stressing the difficulty of initial diagnosis, particularly in the differential diagnosis with Guillain-Barré syndrome. We discuss the importance of nutritional follow-up and the eventual indication of routine vitamin supplementation in these patients.
publisher Academia Brasileira de Neurologia - ABNEURO
publishDate 2006
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000400017
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