Aysha AlShareef1, Omniyah Albaradei1, Hessah Ateeq AlOtaibi2, Mohammed H Alanazy3, Ahmad R Abuzinadah4. 1. Division of Neurology, Department of Internal Medicine, King Abdulaziz University Hospital and College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. 2. Division of Neurology, Department of Internal Medicine, King Fahad General Hospital, Jeddah, Saudi Arabia. 3. Department of Internal Medicine, King Saud University Medical City and College of Medicine, King Saud University, Riyadh, Saudi Arabia. 4. Division of Neurology, Department of Internal Medicine, King Abdulaziz University Hospital and College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, aabuzinadah@kau.edu.sa.
Abstract
INTRODUCTION: The syndrome of post-bariatric surgery axonal polyneuropathy (PAP) may present with various sensory and motor symptoms including paralysis. We aim to describe the diagnostic features and outcome of treatment of the acute paralytic form of PAP (acute paralytic PAP [APPAP]) as it was not described in a separate cohort previously. METHODS: We retrospectively reviewed medical charts and described the clinical, electrodiagnostic features, treatment, and outcome for patients who presented to our clinical neurophysiology unit with disabling weakness within 24 months post-bariatric surgery. The main outcome measure was the percent of patients who are able to walk independently at the last visit and comparing the group who resumed walking independently at 6 months to the group who did not, in regards to the use of intravenous immunoglobulin (IVIg). RESULTS: Thirteen patients were included (10 women and 3 men) with a mean age of 29.8 years (SD 12.5). All presented with loss of ambulation resembling Guillain-Barre Syndrome. The median time of onset was 4 months (interquartile range [IQR] 3-6) post-surgery, and the median time to weakness nadir was 3 weeks (IQR 3-3.5) with an average weight loss of 38.6 kg (SD 17.09). All patients regained their ability to ambulate; however, the ability to walk independently was achieved in 66.7% of patients. The percent of patients who were able to ambulate independently at 6 months were 16% with IVIg versus 66.7% without IVIg. CONCLUSION: The syndrome of -APPAP develops in the first-year post-bariatric surgery. The majority of patients regain independent ambulation.
INTRODUCTION: The syndrome of post-bariatric surgery axonal polyneuropathy (PAP) may present with various sensory and motor symptoms including paralysis. We aim to describe the diagnostic features and outcome of treatment of the acute paralytic form of PAP (acute paralytic PAP [APPAP]) as it was not described in a separate cohort previously. METHODS: We retrospectively reviewed medical charts and described the clinical, electrodiagnostic features, treatment, and outcome for patients who presented to our clinical neurophysiology unit with disabling weakness within 24 months post-bariatric surgery. The main outcome measure was the percent of patients who are able to walk independently at the last visit and comparing the group who resumed walking independently at 6 months to the group who did not, in regards to the use of intravenous immunoglobulin (IVIg). RESULTS: Thirteen patients were included (10 women and 3 men) with a mean age of 29.8 years (SD 12.5). All presented with loss of ambulation resembling Guillain-Barre Syndrome. The median time of onset was 4 months (interquartile range [IQR] 3-6) post-surgery, and the median time to weakness nadir was 3 weeks (IQR 3-3.5) with an average weight loss of 38.6 kg (SD 17.09). All patients regained their ability to ambulate; however, the ability to walk independently was achieved in 66.7% of patients. The percent of patients who were able to ambulate independently at 6 months were 16% with IVIg versus 66.7% without IVIg. CONCLUSION: The syndrome of -APPAP develops in the first-year post-bariatric surgery. The majority of patients regain independent ambulation.
Authors: Victoria Salem; Noara AlHusseini; Habeeb Ibrahim Abdul Razack; Anastasia Naoum; Omar T Sims; Saleh A Alqahtani Journal: Obes Rev Date: 2022-03-26 Impact factor: 10.867