Vom Zusammenhang zwischen bariatrischer Chirurgie und Vitaminen

In the context of unclear neuropsychiatric symptoms, in addition to a profound understanding of the potential causes, a targeted organic clarification is crucial. A comprehensive medical history and interdisciplinary management can guide the way. The diagnostic process will be illustrated in this paper using the specific example of Wernicke’s encephalopathy (WE) due to hypovitaminosis following bariatric surgery. In view of the increasing incidence of interventions WE will be observed more and more frequently, and is of paramount importance because of severe neurological complications. In addition to thorough personal and indirect anamnesis, as well as neurological and physical examination, consultative support, imaging studies, and laboratory investigations are required. In the case of WE, in addition to the Caine criteria, which include malnutrition, oculomotor abnormalities, cerebellar dysfunction, or behavioural changes/memory disorders (at least 2 of the 4 criteria present), cranial magnetic resonance imaging is also of diagnostic value. Early administration of thiamine is crucial for the treatment, prevention, and long-term damage of WE.