Abstract
A 22-year-old woman with a history of idiopathic intracranial hypertension who presented to our emergency department with acute onset strabismus and bilateral sixth nerve palsy in the setting of recent sleeve gastrectomy and vomiting. Further testing revealed multiple vitamin deficiencies, including thiamine, leading to a diagnosis of Wernicke's encephalopathy.
Highlights
A 22-year-old woman with a past medical history significant for idiopathic intracranial hypertension (IICH), morbid obesity status post-gastric sleeve procedure one month ago, presented to the emergency department with complaints of her, “eyes crossing.” Patient notes recent history of gastric sleeve procedure, complicated by significant vomiting that was managed with Zofran
A 22-year-old woman with a history of idiopathic intracranial hypertension who presented to our emergency department with acute onset strabismus and bilateral sixth nerve palsy in the setting of recent sleeve gastrectomy and vomiting
Significant obesity in the 21st century has led to increasing use of bariatric surgery as an effective means to treat and manage the disease and its complications
Summary
A 22-year-old woman with a history of idiopathic intracranial hypertension who presented to our emergency department with acute onset strabismus and bilateral sixth nerve palsy in the setting of recent sleeve gastrectomy and vomiting. Further testing revealed multiple vitamin deficiencies, including thiamine, leading to a diagnosis of Wernicke’s encephalopathy. Incidence of similar presentations is increasing in the setting of rising obesity and increasing usage of minimally invasive surgical techniques for treatment and management of its complications. Emergency physicians must be aware of this occult diagnosis, especially in postbariatric surgery patients complaining of vomiting.
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