Postižení nervového systému z nutriční nedostatečnosti po bariatrických operacích
| Title in English | Disorders of the nervous system arising out of nutritional insufficiency after bariatric surgery |
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| Authors | |
| Year of publication | 2014 |
| Type | Article in Periodical |
| Magazine / Source | Česká a Slovenská neurologie a neurochirurgie |
| MU Faculty or unit | |
| Citation | |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | bariatric surgery; nutritional insufficiency; polyneuropathy |
| Description | In developed countries, nutritional deficiency only rarely causes polyneuropathy or other disorders oi the nervous system. When it does occur, it appears in alcoholics or in the malnourished - people with long-term psychiatric disorders, with gastrointestinal system disorders or on extreme diets. Paradoxically, certain initially obese patients may become malnourished. Pathological obesity is addressed in various ways, with the shared target of restricting food intake. Bariatric surgery is one of the options. However, such a profound diminution of nutri¬tion may induce unpredictable imbalance or insufficiency in nutrients important for normal functioning of the nervous system. The number of bariatric operations is steadily increasing, both in the Czech Republic and elsewhere; in the USA, they already outnumbered cholecys-tectomies. Complications associated with bariatric surgery include polyneuropathy, plexopathy, radiculopathy, myelopathy, encephalopathy and optic neuropathy, all of which may appear both early as well as many years later. The aetiology of these disorders remains unclear, although vitamin insufficiency (thiamine, B12, E), copper deficiency and hypoglycaemia are often held responsible. I lowever, many factors remain hidden and supplementation of the "missing" factors sometimes fails to affect the course of the disease. Damage to the immune system or inflammation may contribute to the aetiology. Weight loss, gastro-intestinal complaints, albumin and transferrin deuease and rehospitalisation for digestive symptoms are considered risk factors. Regular post-surgical monitoring in nutrition centres together with specific treatment of complications is recommended. |