Journal of Community Hospital Internal Medicine Perspectives (Sep 2021)

Wernicke’s encephalopathy mimicking multiple sclerosis in a young female patient post-bariatric gastric sleeve surgery

  • Divya Lal,
  • Maureen C. Farrell,
  • Mahesh Krishnamurthy

DOI
https://doi.org/10.1080/20009666.2021.1949792
Journal volume & issue
Vol. 11, no. 5
pp. 658 – 661

Abstract

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We describe a case of Wernicke’s encephalopathy secondary to thiamine (B1) deficiency in a patient status post-bariatric sleeve gastrectomy. The presenting symptoms of new-onset weakness, diplopia, and confusion in a young female patient raised suspicion for multiple sclerosis (MS), but given a history of bariatric surgery, thiamine levels were checked, revealing significant Vitamin B1 (thiamine) deficiency. This case highlights the importance of thorough history taking, as a misdiagnosis of MS in this case could have resulted in irreversible neurological deterioration and hematological and infectious consequences associated with the inappropriate administration of disease-modifying therapies. It is also important to note that severe vitamin deficiency occurred despite medication compliance.

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