Complicações neurológicas de cirurgia bariátrica: uma revisão da literatura

Abstract

Obesity is a highly prevalent chronic disease, affecting around 33.4% of the Brazilian population. Bariatric surgery stands out as a therapy capable of facilitating significant weight loss in patients. However, as a procedure, it carries many risks, including neurological complications with potentially fatal outcomes, which must be understood in order to prevent, monitor, and appropriately treat unfavorable events. Therefore, it is essential to be aware of the main neurological complications associated with this procedure. OBJECTIVES: To list the main neurological complications following bariatric surgery and describe their primary clinical findings and management, with the aim of contributing to better prevention, recognition, and management of these conditions. METHODS: This is an integrative literature review based on a search in the PubMed MEDLINE database, using the descriptors (bariatric surgery), (neurologic), (neurological), (Wernicke-Korsakoff syndrome), (neuropathy), (encephalopathy), and (post-operative complications), combined using the Boolean operators AND and OR. Complete articles in English or Portuguese were selected, with no time frame restriction. RESULTS: The main complications are vitamin B1 deficiency (beriberi, Wernicke encephalopathy, or Wernicke-Korsakoff syndrome), vitamin B12 deficiency, and copper deficiency. Symptoms, which vary in presentation time, are diverse, including ophthalmoparesis, spasticity, and sensory changes, among others. The prognosis depends on the specific condition, with vitamin B1 deficiency carrying a more guarded outlook. Treatment generally consists of immediate nutritional replacement to prevent permanent deficits. CONCLUSION: Neurological complications following bariatric surgery are primarily related to nutritional deficiencies associated with the procedure. Therefore, ongoing nutritional monitoring and prompt recognition and management of complications are necessary to reduce their impact and improve patients' quality of life.