A Case of Wernicke's Encephalopathy in a Post-Bariatric Surgery Patient in a Community Emergency Department

A 22-year-old woman with a history of idiopathic intracranial hypertension who presented to our emergency department with acute onset strabismus and bilateral sixth nerve palsy in the setting of recent sleeve gastrectomy and vomiting. Further testing revealed multiple vitamin deficiencies, including thiamine, leading to a diagnosis of Wernicke’s encephalopathy. Her symptoms resolved after vitamin and nutritional repletion. Incidence of similar presentations is increasing in the setting of rising obesity and increasing usage of minimally invasive surgical techniques for treatment and management of its complications. Emergency physicians must be aware of this occult diagnosis, especially in post-bariatric surgery patients complaining of vomiting.