ABDÜLKADİR TUNÇ, Azize Esra GURSOY, Vildan GÜZEL

Bariatrik Cerrahi Sonrası Gelişen ve Guillain Barre Sendromu’nu Taklid Eden Poliradikülonöropati Olgusu

Morbid obezite prevalansının artışı ile birlikte bariatrik cerrahi prosedürlerinin sayısı her geçen gün artmakta ve nörolojik komplikasyonlarla daha fazla karşılaşılmaktadır. Bu komplikasyonlar arasında en iyi tanımlanmış olanlar Wernicke ensefalopatisi ve periferik nöropatilerdir. Guillain Barre Sendromu bariatrik cerrahinin çok nadir bir komplikasyonu olarak bildirilmiştir ve bildirilmiş vakalar çoğunlukla aksonal tiptedir. 18 yaşında kadın hasta polikliniğimize kol ve bacaklarda ağrı ve güçsüzlük şikayeti ile başvurdu. Üç ay önce bariatrik cerrahi operasyonu geçirdiği öğrenildi. Alt ekstremitelerde proksimal kas gücü kaybı saptanan hastanın elektrofizyolojik bulguları L3-S1 innerve kaslarda subakut dönem ön kök ön boynuz tutulumu ile uyumlu bulundu. İntravenöz immunglobulin tedavisi sonrası hastada tama yakın düzelme gözlendi. Bariatrik cerrahi sonrası gelişen nörolojik komplikasyonlarda nutrisyonel eksikliklerin yanında enflamatuvar hasarın da göz önünde bulundurulması gerektiği ve bu vakaların kalıcı nörolojik hasarın önlenmesi açısından erken dönemde, multidisipliner bir şekilde takip ve tedavi edilmesi gerektiği görüşündeyiz.

A Case of Polyradiculoneuropathy Mimicking Guillain Barre Syndrome after Bariatric Surgery

With the rising prevalence of morbid obesity, the numbers of bariatric surgical procedures are also increasing, thus resulting in more neurological complications to be recognized. Among these complications, the most well-defined are Wernicke's encephalopathy and peripheral neuropathies. Guillain Barre Syndrome (GBS) has been reported as a very rare complication of bariatric surgery and reported cases are mostly axonal types. An 18-year-old female patient applied to our outpatient clinic with complaints of pain and weakness in her arms and legs. She had bariatric surgery 3 months ago. The electrophysiological findings of the patient who had proximal muscle strength loss in the lower extremities were consistent with subacute anterior root anterior horn involvement in the L3-S1 innervated muscles. After the intravenous immunoglobulin therapy, the patient improved almost completely. We think that in neurological complications after bariatric surgery, nutritional deficiencies should be taken into consideration as well as inflammatory damage and these cases should be followed up and treated in a multidisciplinary manner in order to prevent permanent neurological damage.

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